Brenda Gayle Clark, in Wagoner, OK - Medicare Counselor Provider

Brenda Gayle Clark, is a medicare enrolled "Counselor - Addiction (substance Use Disorder)" provider in Wagoner, Oklahoma. Her current practice location is 109 S. Harrill, Wagoner, Oklahoma. You can reach out to her office (for appointments etc.) via phone at (918) 485-3554.

Brenda Gayle Clark is licensed to practice in * (Not Available) (license number ) 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 1467679175.

Contact Information

	Brenda Gayle Clark,
	109 S. Harrill, Wagoner, OK 74467-5317
	(918) 485-3554
	(918) 485-8371

Map and Direction

Healthcare Provider's Profile

Full Name	Brenda Gayle Clark
Gender	Female
Speciality	Counselor - Addiction (substance Use Disorder)
Location	109 S. Harrill, Wagoner, Oklahoma
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1467679175
Provider Enumeration Date: 04/20/2007
Last Update Date: 07/08/2007

Medicare PECOS Information:

PECOS PAC ID: 0941648216
Enrollment ID: I20240404004405

Medical Identifiers

Medical identifiers for Brenda Gayle Clark such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1467679175	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
101YA0400X	Counselor - Addiction (substance Use Disorder)	(* (Not Available))	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. Brenda Gayle Clark allows following entities to bill medicare on her behalf.

Entity Name	Cherokee Nation
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1780692723 PECOS PAC ID: 5799698742 Enrollment ID: O20031106000628

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. Brenda Gayle 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
Brenda Gayle Clark, 109 S. Harrill, Wagoner, OK 74467-5317 Ph: (918) 485-3554	Brenda Gayle Clark, 109 S. Harrill, Wagoner, OK 74467-5317 Ph: (918) 485-3554

Reviews and Comments

Counselor in Wagoner, OK

James C Washington, Counselor Medicare: Not Enrolled in Medicare Practice Location: 301 Se 11th St, Wagoner, OK 74467 Phone: 918-485-5404 Fax: 918-485-8541
Carleen Noe, Counselor Medicare: Not Enrolled in Medicare Practice Location: 301 Se 11th St, Wagoner, OK 74467 Phone: 918-485-8404 Fax: 918-485-8541
Kamilah Scroggins, Counselor Medicare: Not Enrolled in Medicare Practice Location: 68512 S 310 Rd, Wagoner, OK 74467 Phone: 661-972-8815
Debra Williams, Counselor Medicare: Not Enrolled in Medicare Practice Location: 301 Se 11th St, Wagoner, OK 74467 Phone: 918-485-8404 Fax: 918-485-8541
Tracy Lea Martin, Counselor Medicare: Not Enrolled in Medicare Practice Location: 109 S Harrill, Eri, Wagoner, OK 74467 Phone: 918-485-3554 Fax: 918-485-8371
Angelina C Hayes, Counselor Medicare: Not Enrolled in Medicare Practice Location: 2109 S Highway 69, Wagoner, OK 74467 Phone: 918-485-0242 Fax: 918-485-0204
Madison M Medlock, Counselor Medicare: Not Enrolled in Medicare Practice Location: 109 S Harrill Ave, Wagoner, OK 74467 Phone: 918-485-0242 Fax: 918-485-0242

Brenda Gayle Clark, - Medicare Counselor in Wagoner, OK