Mrs Melba Lynette Clark, in Detroit, MI - Medicare Counselor Provider

Mrs Melba Lynette Clark, is a medicare enrolled "Counselor - Professional" provider in Detroit, Michigan. Her current practice location is 1010 Antietam Ave, Detroit, Michigan. You can reach out to her office (for appointments etc.) via phone at (313) 303-7585.

Mrs Melba Lynette Clark is licensed to practice in Michigan (license number 6401017626) 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 1073158317.

Contact Information

	Mrs Melba Lynette Clark,
	1010 Antietam Ave, Detroit, MI 48207-2832
	(313) 303-7585
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Mrs Melba Lynette Clark
Gender	Female
Speciality	Counselor - Professional
Location	1010 Antietam Ave, Detroit, Michigan
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1073158317
Provider Enumeration Date: 11/11/2019
Last Update Date: 09/11/2025

Medicare PECOS Information:

PECOS PAC ID: 4486095049
Enrollment ID: I20240514001279

Medical Identifiers

Medical identifiers for Mrs Melba Lynette Clark such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1073158317	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
101YP2500X	Counselor - Professional	6401017626 (Michigan)	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 Melba Lynette Clark allows following entities to bill medicare on her behalf.

Entity Name	A Path To Peace Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1083259345 PECOS PAC ID: 1759722317 Enrollment ID: O20240514001115

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 Melba Lynette 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
Mrs Melba Lynette Clark, 1010 Antietam Ave, Detroit, MI 48207-2832 Ph: (313) 671-3188	Mrs Melba Lynette Clark, 1010 Antietam Ave, Detroit, MI 48207-2832 Ph: (313) 303-7585

Reviews and Comments

Counselor in Detroit, MI

Anthony Jerome Allen, AAS., CAC II Counselor Medicare: Not Enrolled in Medicare Practice Location: 12010 Linwood St, Detroit, MI 48206 Phone: 313-867-1090 Fax: 313-867-0706
Mr. Brian R Cogliati, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1852 W Grand Blvd, 1852 W. Grand Blvd, Detroit, MI 48208 Phone: 313-894-8444 Fax: 313-894-5542
Mr. Gregory Charles Guice, MA Counselor Medicare: Not Enrolled in Medicare Practice Location: 1151 Taylor Ave., Detroit, MI 48202 Phone: 313-874-8715
Ms. Carol Potter, MA, BCBA, LBA Counselor Medicare: Not Enrolled in Medicare Practice Location: 2200 Hunt St, Detroit, MI 48207 Phone: 248-537-2516
Mrs. Lisa Polk-woolfolk, MS, LLPC, CAC-M Counselor Medicare: Not Enrolled in Medicare Practice Location: 3731 Rivard St, Detroit, MI 48207 Phone: 313-258-9713
Alicia Monique Lurry, LPC Counselor Medicare: Medicare Enrolled Practice Location: 8171 Parkland, Detroit, MI 48239 Phone: 313-282-7567
Mr. Darren Kilgore, Counselor Medicare: Not Enrolled in Medicare Practice Location: 269 Walker St, 538, Detroit, MI 48207 Phone: 313-610-0134

Mrs Melba Lynette Clark, - Medicare Counselor in Detroit, MI