Ms Edith Susan Root-clark, LMSW, CAADC is a medicare enrolled "Social Worker - Clinical" provider in Detroit, Michigan. Her current practice location is
4646 John R St, Detroit, Michigan. You can reach out to her office (for appointments etc.) via phone at
(313) 576-1000.
Ms Edith Susan Root-clark is licensed to practice in Michigan (license number 6801090621) 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 1689827768.
Healthcare Provider's Profile
| Full Name | Ms Edith Susan Root-clark |
|---|
| Gender | Female |
|---|
| Speciality | Social Worker - Clinical |
|---|
| Location | 4646 John R St, Detroit, Michigan |
|---|
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
|---|
NPI Data:
- NPI Number: 1689827768
- Provider Enumeration Date: 11/03/2008
- Last Update Date: 01/09/2020
Medicare PECOS Information:
- PECOS PAC ID: 2365863685
- Enrollment ID: I20200521003018
Medical Identifiers
Medical identifiers for Ms Edith Susan Root-clark such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1689827768 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | C-01836 (Michigan) | Secondary |
| 1041C0700X | Social Worker - Clinical | 6801090621 (Michigan) | 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. Ms Edith Susan Root-clark allows following entities to bill medicare on her behalf.
| Entity Name | Gps Guide To Personal Solutions |
|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
|---|
| Entity Identifiers | NPI Number: 1114367380
PECOS PAC ID: 4385864768
Enrollment ID: O20141007001183 |
|---|
| Entity Name | Michigan Institute Of Performance And Health |
|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
|---|
| Entity Identifiers | NPI Number: 1174041321
PECOS PAC ID: 3779840442
Enrollment ID: O20171205002478 |
|---|
| Entity Name | Whole & Inclusive Counseling Pllc |
|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
|---|
| Entity Identifiers | NPI Number: 1548740723
PECOS PAC ID: 5799115192
Enrollment ID: O20200427002130 |
|---|
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. Ms Edith Susan Root-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 |
|---|
Ms Edith Susan Root-clark, LMSW, CAADC
4646 John R St,
Detroit, MI 48201-1916
Ph: (313) 576-1000 | Ms Edith Susan Root-clark, LMSW, CAADC
4646 John R St,
Detroit, MI 48201-1916
Ph: (313) 576-1000 |
Reviews and Comments