Dominique Monche' Clark, LCSW is a medicare enrolled "Social Worker - Clinical" provider in Walls, Mississippi. She graduated from medical school in 2015 and has 11 years of diverse experience with area of expertise as Clinical Social Worker. She is a member of the group practice Uppal Medical Center Llc, Supportive Psych Care Of Arkansas Pa and her current practice location is
6551 Anna May Dr, Walls, Mississippi. You can reach out to her office (for appointments etc.) via phone at
(901) 359-1283.
Dominique Monche' Clark is licensed to practice in Mississippi (license number C10935) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1871345892.
Healthcare Provider's Profile
| Full Name | Dominique Monche' Clark |
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| Gender | Female |
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| Speciality | Clinical Social Worker |
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| Experience | 11 Years |
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| Location | 6551 Anna May Dr, Walls, Mississippi |
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| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Medical Education and Training:
- Dominique Monche' Clark graduated from medical school in 2015
NPI Data:
- NPI Number: 1871345892
- Provider Enumeration Date: 04/03/2024
- Last Update Date: 05/19/2025
Medicare PECOS Information:
- PECOS PAC ID: 8426577636
- Enrollment ID: I20250521001200
Medical Identifiers
Medical identifiers for Dominique Monche' Clark such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
| 1871345892 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
| 1041C0700X | Social Worker - Clinical | C10935 (Mississippi) | Primary |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
| Uppal Medical Center Llc | 4587998547 | 63 |
| Supportive Psych Care Of Arkansas Pa | 8820474661 | 28 |
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. Dominique Monche' Clark allows following entities to bill medicare on her behalf.
| Entity Name | Supportive Psych Care Of Arkansas Pa |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1437887437 PECOS PAC ID: 8820474661 Enrollment ID: O20221003001887 |
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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. Dominique Monche' 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 |
Dominique Monche' Clark, LCSW 6551 Anna May Dr, Walls, MS 38680-9214 Ph: (901) 359-1283 | Dominique Monche' Clark, LCSW 6551 Anna May Dr, Walls, MS 38680-9214 Ph: (901) 359-1283 |
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