Dr Kevin Joseph Mack, PSYD is a medicare enrolled "Psychologist - Clinical" provider in Covelo, California. He graduated from medical school in 1991 and has 33 years of diverse experience with area of expertise as Clinical Psychologist. He is a member of the group practice Round Valley Indian Health Center, Inc. and his current practice location is
23000 Henderson Road, Covelo, California. You can reach out to his office (for appointments etc.) via phone at
(707) 983-6648.
Dr Kevin Joseph Mack is licensed to practice in California (license number PSY 12983) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1760416903.
Healthcare Provider's Profile
| Full Name | Dr Kevin Joseph Mack |
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| Gender | Male |
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| Speciality | Clinical Psychologist |
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| Experience | 33 Years |
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| Location | 23000 Henderson Road, Covelo, California |
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| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Dr Kevin Joseph Mack graduated from medical school in 1991
NPI Data:
- NPI Number: 1760416903
- Provider Enumeration Date: 07/11/2006
- Last Update Date: 07/09/2018
Medicare PECOS Information:
- PECOS PAC ID: 2769674233
- Enrollment ID: I20101004000418
Medical Identifiers
Medical identifiers for Dr Kevin Joseph Mack such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1760416903 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 103TC0700X | Psychologist - Clinical | PSY 12983 (California) | Primary |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Round Valley Indian Health Center, Inc. | 9234128927 | 7 |
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 Kevin Joseph Mack allows following entities to bill medicare on his behalf.
| Entity Name | Round Valley Indian Health Center, Inc. |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1669532750
PECOS PAC ID: 9234128927
Enrollment ID: O20040507001316 |
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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 Kevin Joseph Mack 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 |
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Dr Kevin Joseph Mack, PSYD
Po Box 247,
Covelo, CA 95428-0247
Ph: (707) 983-6648 | Dr Kevin Joseph Mack, PSYD
23000 Henderson Road,
Covelo, CA 95428-0247
Ph: (707) 983-6648 |
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