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Charles Alan Clearwater

Social Worker

Behavioral Health & Social Service Providers

3084 Grandview Dr, Allegan, MI 49010-9506

PECOS Enrollment

This provider is enrolled in PECOS as CHARLES CLEARWATER.

Based on the most recent information from CMS, provider Charles Alan Clearwater is legally eligible to order and refer claims for Part B and DME services only.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 4 days ago.

Profile Details

Provider ID
1790134740
Provider Type
Individual
Full Name
Clearwater, Charles Alan
Title
Mr.
Credential
LMSW, MED

Gender
Male
Sole Proprietor
Yes
Enumeration Date
6/10/2016
Last Updated
11/27/2023

Contact Information

Practice Location

3084 Grandview Dr, Allegan, MI 49010-9506

(269) 744-6138

Unlisted Fax

Mailing Location

3084 Grandview Dr, Allegan, MI 49010-9506

(269) 744-6138

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 1041C0700X Primary	Description Social Worker Behavioral Health & Social Service Providers	License 6801088097 Michigan

Charles Alan Clearwater

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

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