Mrs Angela Johan Clark, LPC, LPCC, NCC in Grass Valley, CA

Mrs Angela Johan Clark, LPC, LPCC, NCC is a medicare enrolled "Counselor - Professional" provider in Grass Valley, California. Her current practice location is 673 S Auburn St, Grass Valley, California. You can reach out to her office (for appointments etc.) via phone at (530) 913-7221.

Mrs Angela Johan Clark is licensed to practice in California (license number 13646) 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 1013425578.

Contact Information

	Mrs Angela Johan Clark, LPC, LPCC, NCC
	673 S Auburn St, Grass Valley, CA 95945-7576
	(530) 913-7221
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Mrs Angela Johan Clark
Gender	Female
Speciality	Counselor - Professional
Location	673 S Auburn St, Grass Valley, California
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1013425578
Provider Enumeration Date: 01/18/2018
Last Update Date: 06/01/2023

Medicare PECOS Information:

PECOS PAC ID: 3476992413
Enrollment ID: I20240423003244

Medical Identifiers

Medical identifiers for Mrs Angela Johan Clark such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1013425578	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
101YP2500X	Counselor - Professional	2017043804 (Missouri)	Secondary
101YP2500X	Counselor - Professional	13646 (California)	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. Mrs Angela Johan Clark allows following entities to bill medicare on her behalf.

Entity Name	Sierra Family Therapy Centers, Inc.
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1336648385 PECOS PAC ID: 6608210752 Enrollment ID: O20240216003242

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. Mrs Angela Johan 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
Mrs Angela Johan Clark, LPC, LPCC, NCC 3121 Sweetwater Springs Blvd Apt 78, Spring Valley, CA 91978-1530 Ph: (816) 548-7673	Mrs Angela Johan Clark, LPC, LPCC, NCC 673 S Auburn St, Grass Valley, CA 95945-7576 Ph: (530) 913-7221

Reviews and Comments

Counselor in Grass Valley, CA

Seth Thomas Derrick, Counselor Medicare: Not Enrolled in Medicare Practice Location: 900 E Main St Ste 201, Grass Valley, CA 95945 Phone: 530-802-6993
Westlie Aguilar, Counselor Medicare: Not Enrolled in Medicare Practice Location: 714 W Main St, Grass Valley, CA 95945 Phone: 530-477-9800
Samuel Sebastian Echeverria, Counselor Medicare: Not Enrolled in Medicare Practice Location: 500 Crown Point Cir Ste 100, Grass Valley, CA 95945 Phone: 530-273-5440
Mr. Daniel H. Peters, CATC-II Counselor Medicare: Not Enrolled in Medicare Practice Location: 180 Sierra College Dr, Grass Valley, CA 95945 Phone: 530-273-9541 Fax: 530-273-7740
Mr. Joseph Adam Naake, RADTI Counselor Medicare: Not Enrolled in Medicare Practice Location: 256 Buena Vista St, Grass Valley, CA 95945 Phone: 530-274-2000 Fax: 530-274-2116
Bryan Lassegard, Counselor Medicare: Not Enrolled in Medicare Practice Location: 714 W Main St, Grass Valley, CA 95945 Phone: 530-477-9800 Fax: 530-477-9803

Mrs Angela Johan Clark, LPC, LPCC, NCC - Medicare Counselor in Grass Valley, CA