Brianna C Bourne, is a medicare enrolled "Social Worker - Clinical" provider in Pueblo, Colorado. Her current practice location is
1012 W Abriendo Ave, Pueblo, Colorado. You can reach out to her office (for appointments etc.) via phone at
(719) 545-2746.
Brianna C Bourne is licensed to practice in Colorado (license number CSW.09923877) 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 1336482975.
Healthcare Provider's Profile
| Full Name | Brianna C Bourne |
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| Gender | Female |
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| Speciality | Social Worker - Clinical |
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| Location | 1012 W Abriendo Ave, Pueblo, Colorado |
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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: 1336482975
- Provider Enumeration Date: 04/02/2013
- Last Update Date: 02/16/2017
Medicare PECOS Information:
- PECOS PAC ID: 6204129588
- Enrollment ID: I20160725001036
Medical Identifiers
Medical identifiers for Brianna C Bourne such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1336482975 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 101YA0400X | Counselor - Addiction (substance Use Disorder) | ACD.0000451 (Colorado) | Secondary |
| 1041C0700X | Social Worker - Clinical | CSW.09923877 (Colorado) | 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. Brianna C Bourne allows following entities to bill medicare on her behalf.
| Entity Name | Sondermind Provider Network Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1760854442
PECOS PAC ID: 9537572490
Enrollment ID: O20210113002826 |
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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. Brianna C Bourne 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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Brianna C Bourne,
41 Montebello Rd, Suite 200,
Pueblo, CO 81001-1379
Ph: (719) 545-2746 | Brianna C Bourne,
1012 W Abriendo Ave,
Pueblo, CO 81004-1128
Ph: (719) 545-2746 |
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