Dr Julie D Clark, PHD is a medicare enrolled "Counselor - Mental Health" provider in Ponca City, Oklahoma. Her current practice location is
200 White Eagle Dr, Ponca City, Oklahoma. You can reach out to her office (for appointments etc.) via phone at
(580) 762-3421.
Dr Julie D Clark is licensed to practice in * (Not Available) (license number ) 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 1487084968.
Healthcare Provider's Profile
Full Name | Dr Julie D Clark |
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Gender | Female |
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Speciality | Counselor - Mental Health |
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Location | 200 White Eagle Dr, Ponca City, Oklahoma |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1487084968
- Provider Enumeration Date: 11/19/2013
- Last Update Date: 03/12/2019
Medicare PECOS Information:
- PECOS PAC ID: 4284008038
- Enrollment ID: I20240208001667
Medical Identifiers
Medical identifiers for Dr Julie D Clark such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1487084968 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
103TC1900X | Psychologist - Counseling | (* (Not Available)) | Secondary |
101YM0800X | Counselor - Mental Health | (* (Not Available)) | 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. Dr Julie D Clark allows following entities to bill medicare on her behalf.
Entity Name | White Eagle Health Center |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1699875724 PECOS PAC ID: 1456324193 Enrollment ID: O20040819000518 |
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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. Dr Julie D 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 |
Dr Julie D Clark, PHD 200 White Eagle Dr, Ponca City, OK 74601-8315 Ph: (580) 762-3421 | Dr Julie D Clark, PHD 200 White Eagle Dr, Ponca City, OK 74601-8315 Ph: (580) 762-3421 |
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