Mrs Jerylyn Bohlender, LCSW is a medicare enrolled "Social Worker - Clinical" provider in Clearlake, California. Her current practice location is
15230 Lakeshore Dr, Clearlake, California. You can reach out to her office (for appointments etc.) via phone at
(707) 995-4500.
Mrs Jerylyn Bohlender is licensed to practice in California (license number 91534) 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 1750782488.
Healthcare Provider's Profile
| Full Name | Mrs Jerylyn Bohlender |
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| Gender | Female |
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| Speciality | Social Worker - Clinical |
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| Location | 15230 Lakeshore Dr, Clearlake, California |
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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: 1750782488
- Provider Enumeration Date: 09/12/2014
- Last Update Date: 02/02/2022
Medicare PECOS Information:
- PECOS PAC ID: 6204221369
- Enrollment ID: I20220328001663
Medical Identifiers
Medical identifiers for Mrs Jerylyn Bohlender such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
| 1750782488 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | RW8734 (California) | Secondary |
| 1041C0700X | Social Worker - Clinical | 91534 (California) | 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. Mrs Jerylyn Bohlender allows following entities to bill medicare on her behalf.
| Entity Name | Adventist Health Clearlake Hospital Inc. |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1124018031 PECOS PAC ID: 3072421197 Enrollment ID: O20041112000573 |
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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. Mrs Jerylyn Bohlender 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 |
Mrs Jerylyn Bohlender, LCSW 15230 Lakeshore Dr, Clearlake, CA 95422-8107 Ph: (707) 995-4500 | Mrs Jerylyn Bohlender, LCSW 15230 Lakeshore Dr, Clearlake, CA 95422-8107 Ph: (707) 995-4500 |
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