Kristina M Clark, LPC in Charleston, WV - Medicare Counselor Provider

Kristina M Clark, LPC is a medicare enrolled "Counselor - Mental Health" provider in Charleston, West Virginia. Her current practice location is 511 Morris St, Charleston, West Virginia. You can reach out to her office (for appointments etc.) via phone at (304) 525-7851.

Kristina M Clark is licensed to practice in West Virginia (license number 2398) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1083173702.

Contact Information

	Kristina M Clark, LPC
	511 Morris St, Charleston, WV 25301-1326
	(304) 525-7851
	(304) 525-1073

Map and Direction

Healthcare Provider's Profile

Full Name	Kristina M Clark
Gender	Female
Speciality	Counselor - Mental Health
Location	511 Morris St, Charleston, West Virginia
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1083173702
Provider Enumeration Date: 03/13/2019
Last Update Date: 09/05/2024

Medicare PECOS Information:

PECOS PAC ID: 2264873066
Enrollment ID: I20240510001556

Medical Identifiers

Medical identifiers for Kristina M Clark such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1083173702	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
101YM0800X	Counselor - Mental Health	2398 (West Virginia)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Kristina M Clark allows following entities to bill medicare on her behalf.

Entity Name	Prestera Center For Mental Health Services Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1356336903 PECOS PAC ID: 9234029307 Enrollment ID: O20040319001328

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Kristina M Clark is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Kristina M Clark, LPC 99 Cracker Barrel Dr Ste 100, Barboursville, WV 25504-1650 Ph: (304) 525-7851	Kristina M Clark, LPC 511 Morris St, Charleston, WV 25301-1326 Ph: (304) 525-7851

Reviews and Comments

Counselor in Charleston, WV

Jatue Richardson, BA Counselor Medicare: Not Enrolled in Medicare Practice Location: 2157 Greenbrier St, Charleston, WV 25311 Phone: 304-344-5924 Fax: 304-344-3503
James M Jackson, COUNSELOR 3 Counselor Medicare: Not Enrolled in Medicare Practice Location: 2157 Greenbrier St, Charleston, WV 25311 Phone: 304-344-5924 Fax: 304-344-3503
Jill Leean Woodrum, Counselor Medicare: Not Enrolled in Medicare Practice Location: 2157 Greenbrier St, Charleston, WV 25311 Phone: 304-344-5924
Denise Briscoe, MA, LSW Counselor Medicare: Not Enrolled in Medicare Practice Location: 1206 Quarrier St, Charleston, WV 25301 Phone: 304-513-3900
Hope Hartz, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 1632 Kanawha Blvd E, Charleston, WV 25311 Phone: 304-344-8515
Ethel Austin, BSW Counselor Medicare: Not Enrolled in Medicare Practice Location: 2157 Greenbrier St, Charleston, WV 25311 Phone: 304-245-9753 Fax: 304-344-3503
Khadija Myers, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1206 Quarrier St, Charleston, WV 25301 Phone: 304-513-3900

Kristina M Clark, LPC - Medicare Counselor in Charleston, WV