Ms Edith Susan Root-clark, LMSW, CAADC is a medicare enrolled "Social Worker - Clinical" provider in Detroit, Michigan. She graduated from healthcare school in 2008 and has 17 years of diverse experience with area of expertise as Clinical Social Worker. She is a member of the group practice Gps Guide To Personal Solutions and her current practice location is
4646 John R St, Detroit, Michigan. You can reach out to her office (for appointments etc.) via phone at
(313) 576-1000.
Ms Edith Susan Root-clark is licensed to practice in Michigan (license number 6801090621) 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 1689827768.
Healthcare Provider's Profile
| Full Name | Ms Edith Susan Root-clark |
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| Gender | Female |
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| Speciality | Clinical Social Worker |
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| Experience | 17 Years |
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| Location | 4646 John R St, Detroit, Michigan |
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| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Ms Edith Susan Root-clark graduated from medical school in 2008
NPI Data:
- NPI Number: 1689827768
- Provider Enumeration Date: 11/03/2008
- Last Update Date: 01/09/2020
Medicare PECOS Information:
- PECOS PAC ID: 2365863685
- Enrollment ID: I20200521003018
Medical Identifiers
Medical identifiers for Ms Edith Susan Root-clark such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1689827768 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 101YA0400X | Counselor - Addiction (substance Use Disorder) | C-01836 (Michigan) | Secondary |
| 1041C0700X | Social Worker - Clinical | 6801090621 (Michigan) | Primary |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|
| Gps Guide To Personal Solutions | 4385864768 | 3 |
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. Ms Edith Susan Root-clark allows following entities to bill medicare on her behalf.
| Entity Name | Gps Guide To Personal Solutions |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1114367380
PECOS PAC ID: 4385864768
Enrollment ID: O20141007001183 |
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| Entity Name | Michigan Institute Of Performance And Health |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1174041321
PECOS PAC ID: 3779840442
Enrollment ID: O20171205002478 |
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| Entity Name | Whole & Inclusive Counseling Pllc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1548740723
PECOS PAC ID: 5799115192
Enrollment ID: O20200427002130 |
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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. Ms Edith Susan Root-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 |
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Ms Edith Susan Root-clark, LMSW, CAADC
4646 John R St,
Detroit, MI 48201-1916
Ph: (313) 576-1000 | Ms Edith Susan Root-clark, LMSW, CAADC
4646 John R St,
Detroit, MI 48201-1916
Ph: (313) 576-1000 |
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