Mr Randolph Laird Clark, MSW, LCSW in Avon, IN - Medicare Social Worker Provider

Mr Randolph Laird Clark, MSW, LCSW is a medicare enrolled "Social Worker - Clinical" provider in Avon, Indiana. His current practice location is 6655 E Us Highway 36, Avon, Indiana. You can reach out to his office (for appointments etc.) via phone at (888) 714-1927.

Mr Randolph Laird Clark is licensed to practice in Indiana (license number 34007681A) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1245665363.

Contact Information

	Mr Randolph Laird Clark, MSW, LCSW
	6655 E Us Highway 36, Avon, IN 46123-8923
	(888) 714-1927
	(317) 272-0807

Map and Direction

Healthcare Provider's Profile

Full Name	Mr Randolph Laird Clark
Gender	Male
Speciality	Social Worker - Clinical
Location	6655 E Us Highway 36, Avon, Indiana
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1245665363
Provider Enumeration Date: 09/09/2013
Last Update Date: 11/23/2021

Medicare PECOS Information:

PECOS PAC ID: 2365727187
Enrollment ID: I20170317001323

Medical Identifiers

Medical identifiers for Mr Randolph Laird Clark such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1245665363	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
1041C0700X	Social Worker - Clinical	34007681A (Indiana)	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. Mr Randolph Laird Clark allows following entities to bill medicare on his behalf.

Entity Name	Cummins Behavioral Health Systems, Incorporated
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1740232115 PECOS PAC ID: 1850296302 Enrollment ID: O20031206000039

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. Mr Randolph Laird 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
Mr Randolph Laird Clark, MSW, LCSW 5101 E. Us Hwy 36, Suite 100, Avon, IN 46123-6646 Ph: (888) 714-1927	Mr Randolph Laird Clark, MSW, LCSW 6655 E Us Highway 36, Avon, IN 46123-8923 Ph: (888) 714-1927

Reviews and Comments

Social Worker in Avon, IN

Mr. Chris C Hamm, LCSW, ACSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 6655 E Us Highway 36, Avon, IN 46123 Phone: 317-272-3334 Fax: 317-272-3331
Christina Davis, Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 7315 Autumn Ct, Avon, IN 46123 Phone: 317-627-2483
Madelyn Taylor Hardwick, Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 6845 E Us Highway 36 Ste 500, Avon, IN 46123 Phone: 812-247-8010
M Dawn Newman, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 6655 E U S 36, Avon, IN 46123 Phone: 317-272-3330 Fax: 317-272-3331
Bryon L Ross, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 6655 E Us Highway 36, Avon, IN 46123 Phone: 317-272-3330 Fax: 317-272-0807
Mrs. Tamara Maxine Vanwinkle, MSW, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 6655 E Us Highway 36, Avon, IN 46123 Phone: 317-272-3330 Fax: 317-272-0807
Mrs. Gina B Platten, MSW, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 6655 E Us Highway 36, Avon, IN 46123 Phone: 888-714-1927

Mr Randolph Laird Clark, MSW, LCSW - Medicare Clinical Social Worker in Avon, IN