ANDREW CLARK PACANOWSKI (LPC) – Professional Counselor, NPI 1174307417

ANDREW CLARK PACANOWSKI (LPC) is a healthcare provider. based in Wichita falls, Texas. specializing in MENTAL HEALTH COUNSELOR. They hold the professional credentials LPC. They hold a License No. 84081 (TX). The NPI Number for ANDREW CLARK PACANOWSKI (LPC) is 1174307417

Main info

Male
8 Years Of Experience
Accepts Medicare Assignment
Name
ANDREW CLARK PACANOWSKI (LPC)
NPI
1174307417
Phone
(940) 691-1899
Address
4722 TAFT BLVD STE 2
Enumeration Date
18 August 2023
Last Update Date
18 August 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9406911899
Graduation Year
2018 (8 years ago)
PAC ID
7810406956
Group Practice PAC ID
1254581564
Professional Enrollment ID
I20250806004683
Address ID
TX763081017WI2934XBLVD300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience28
Completeness75
Years active:2State licenses:1Digital endpointsOther names

3,949 MENTAL HEALTH COUNSELOR in TX

Provider Addresses for ANDREW CLARK PACANOWSKI (LPC)

  • 4722 TAFT BLVD STE 2

    WICHITA FALLS, TX 763084800

    Phone: (940) 691-1899

    Fax: (940) 691-3423

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-08-06

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20250806004683IMental Health CounselorTXTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 76308)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 1254581564View full group profile
NameSpecialtyState
Mental Health CounselorTX
Nurse PractitionerTX
Clinical PsychologistTX
Mental Health CounselorTX
Mental Health CounselorTX
Clinical PsychologistTX

Reviews

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Frequently asked questions

How do payers reference ANDREW CLARK PACANOWSKI (LPC)?
For ANDREW CLARK PACANOWSKI (LPC), use NPI 1174307417 as the unique 10-digit identifier.
Is ANDREW CLARK PACANOWSKI (LPC) shown as active in public data?
Registry records indicate ANDREW CLARK PACANOWSKI (LPC) maintains an active NPI.
How would a patient describe ANDREW CLARK PACANOWSKI (LPC)'s focus?
For ANDREW CLARK PACANOWSKI (LPC), the primary taxonomy reads as Professional Counselor. Clinical services aligned with this taxonomy classification.
Is ANDREW CLARK PACANOWSKI (LPC) located near Wichita Falls?
ANDREW CLARK PACANOWSKI (LPC) currently maps to Wichita Falls, Texas in this extract.
Does ANDREW CLARK PACANOWSKI (LPC) accept insurance?
Insurance participation is not part of the core NPI extract — call the plan or office to confirm.

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