Dominique Monche' Clark, LCSW - Medicare Clinical Social Worker in Walls, MS

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Dominique Monche' Clark, LCSW is a medicare enrolled "Social Worker - Clinical" provider in Walls, Mississippi. 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 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 1871345892.

Contact Information

Dominique Monche' Clark, LCSW
6551 Anna May Dr,
Walls, MS 38680-9214
(901) 359-1283
Not Available

Map and Direction




Healthcare Provider's Profile

Full NameDominique Monche' Clark
GenderFemale
SpecialitySocial Worker - Clinical
Location6551 Anna May Dr, Walls, Mississippi
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  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.
IdentifierTypeStateIssuer
1871345892NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
1041C0700XSocial Worker - Clinical C10935 (Mississippi)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. Dominique Monche' Clark allows following entities to bill medicare on her behalf.
Entity NameSupportive Psych Care Of Arkansas Pa
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1437887437
PECOS PAC ID: 8820474661
Enrollment ID: O20221003001887

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 AddressPractice 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

Reviews and Comments


Social Worker in Walls, MS

Wendy Mckenzie,
Clinical Social Worker
Medicare: Not Enrolled in Medicare
Practice Location: 6915 Slash Pine Dr, Walls, MS 38680
Phone: 662-655-8553    
Jessica Davis, LCSW
Clinical Social Worker
Medicare: Not Enrolled in Medicare
Practice Location: 6502 Mccoy Cv, Walls, MS 38680
Phone: 662-444-4949    

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.