Susan Clark, LCSW is a medicare enrolled "Social Worker - Clinical" provider in Louisville, Kentucky. Her current practice location is
914 E Broadway, 3rd Floor, Louisville, Kentucky. You can reach out to her office (for appointments etc.) via phone at
(502) 589-8600.
Susan Clark is licensed to practice in Kentucky (license number 5049) 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 1619268422.
Healthcare Provider's Profile
| Full Name | Susan Clark |
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| Gender | Female |
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| Speciality | Social Worker - Clinical |
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| Location | 914 E Broadway, Louisville, Kentucky |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1619268422
- Provider Enumeration Date: 04/27/2011
- Last Update Date: 11/03/2015
Medicare PECOS Information:
- PECOS PAC ID: 2365743366
- Enrollment ID: I20151216002097
Medical Identifiers
Medical identifiers for Susan Clark such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1619268422 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 106H00000X | Marriage & Family Therapist | 2013-007 (Kentucky) | Secondary |
| 1041C0700X | Social Worker - Clinical | 5049 (Kentucky) | 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. Susan Clark allows following entities to bill medicare on her behalf.
| Entity Name | Joshuas House |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1013695352
PECOS PAC ID: 1254865694
Enrollment ID: O20241107004062 |
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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. Susan 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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Susan Clark, LCSW
101 W Muhammad Ali Blvd,
Louisville, KY 40202-1423
Ph: () - | Susan Clark, LCSW
914 E Broadway, 3rd Floor,
Louisville, KY 40204-1037
Ph: (502) 589-8600 |
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