Amy Clark, LCSW, SAC is a medicare enrolled "Social Worker - Clinical" provider in Franklin, Wisconsin. Her current practice location is
9200 W Loomis Rd Ste 217, Franklin, Wisconsin. You can reach out to her office (for appointments etc.) via phone at
(414) 773-4312.
Amy Clark is licensed to practice in Wisconsin (license number 8789-123) 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 1851898233.
Healthcare Provider's Profile
| Full Name | Amy Clark |
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| Gender | Female |
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| Speciality | Social Worker - Clinical |
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| Location | 9200 W Loomis Rd Ste 217, Franklin, Wisconsin |
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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: 1851898233
- Provider Enumeration Date: 04/11/2018
- Last Update Date: 06/05/2024
Medicare PECOS Information:
- PECOS PAC ID: 9931456209
- Enrollment ID: I20180717003993
Medical Identifiers
Medical identifiers for Amy Clark such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
| 1851898233 | NPI | - | NPPES |
| 100077875 | Medicaid | WI | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 16182-132 (Wisconsin) | Secondary |
| 1041C0700X | Social Worker - Clinical | 8789-123 (Wisconsin) | 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. Amy Clark allows following entities to bill medicare on her behalf.
| Entity Name | Aurora Medical Group, Inc. |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1427271378 PECOS PAC ID: 6709794258 Enrollment ID: O20031105000725 |
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| Entity Name | Psychiatric & Psychotherapy Clinic L I Newman Md Sc Gen Ptr |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1932312212 PECOS PAC ID: 0547200198 Enrollment ID: O20050503001288 |
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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. Amy 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 |
Amy Clark, LCSW, SAC 9200 W Loomis Rd Ste 217, Franklin, WI 53132-8887 Ph: (414) 773-4312 | Amy Clark, LCSW, SAC 9200 W Loomis Rd Ste 217, Franklin, WI 53132 Ph: (414) 773-4312 |
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