Gracia Clark, in Hudson, WI - Medicare Mental Health Counselor Provider

Gracia Clark, is a medicare enrolled "Counselor - Professional" provider in Hudson, Wisconsin. She graduated from healthcare school in 2019 and has 7 years of diverse experience with area of expertise as Mental Health Counselor. She is a member of the group practice Lakeview Memorial Hospital Association, Inc. and her current practice location is 403 Stageline Rd, Hudson, Wisconsin. You can reach out to her office (for appointments etc.) via phone at (715) 531-6700.

Gracia Clark is licensed to practice in Wisconsin (license number 8447) 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 1417602251.

Contact Information

	Gracia Clark,
	403 Stageline Rd, Hudson, WI 54016-7848
	(715) 531-6700
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Gracia Clark
Gender	Female
Speciality	Mental Health Counselor
Experience	7 Years
Location	403 Stageline Rd, Hudson, Wisconsin
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:

Gracia Clark graduated from medical school in 2019

NPI Data:

NPI Number: 1417602251
Provider Enumeration Date: 02/21/2022
Last Update Date: 05/12/2025

Medicare PECOS Information:

PECOS PAC ID: 6103269592
Enrollment ID: I20240213003389

Medical Identifiers

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

Identifier	Type	State	Issuer
1417602251	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
101Y00000X	Counselor	8447 (Wisconsin)	Secondary
101YP2500X	Counselor - Professional	8447 (Wisconsin)	Primary

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Lakeview Memorial Hospital Association, Inc.	1951210855	14

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. Gracia Clark allows following entities to bill medicare on her behalf.

Entity Name	Lakeview Memorial Hospital Association, Inc.
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1821114729 PECOS PAC ID: 1951210855 Enrollment ID: O20031104000543

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. Gracia 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
Gracia Clark, 8170 33rd Ave S # Ms 21110q, Bloomington, MN 55425-4516 Ph: () -	Gracia Clark, 403 Stageline Rd, Hudson, WI 54016-7848 Ph: (715) 531-6700

Reviews and Comments

Counselor in Hudson, WI

Brittany Iczkowski, LPCC, LADC, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 522 2nd Street #102, Hudson, WI 54016 Phone: 715-204-9840
Rochelle K Anderson, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 2910 Enloe St Ste 100, Hudson, WI 54016 Phone: 715-381-5437 Fax: 715-381-5438
Ms. Joan N Fuller, MA, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 901 4th St, Suite 160, Hudson, WI 54016 Phone: 763-210-9966 Fax: 763-210-6886
Renee L. Vannocker, MS Counselor Medicare: Not Enrolled in Medicare Practice Location: 2910 Enloe St, Ste 100, Hudson, WI 54016 Phone: 715-381-5437 Fax: 715-381-5438
Anastazia Acker, M.S. Counselor Medicare: Not Enrolled in Medicare Practice Location: 690 Elizabeth Way Apt 226, Hudson, WI 54016 Phone: 612-293-8830
Ms. Amanda Rose Lemay, LPCC, LPC Counselor Medicare: Medicare Enrolled Practice Location: 901 Dominion Dr, Hudson, WI 54016 Phone: 715-808-8070
Daniel Patrick Jordan, Counselor Medicare: Not Enrolled in Medicare Practice Location: 900 Crest View Dr Ste 120, Hudson, WI 54016 Phone: 651-292-2434

Gracia Clark, - Medicare Counselor in Hudson, WI