Olivia Jenai Burlison, is a medicare enrolled "Social Worker - Clinical" provider in West Bloomfield, Michigan. Her current practice location is
2300 Haggerty Rd Ste 2160, West Bloomfield, Michigan. You can reach out to her office (for appointments etc.) via phone at
(248) 859-2457.
Olivia Jenai Burlison is licensed to practice in Michigan (license number 6801110678) 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 1235619222.
Healthcare Provider's Profile
| Full Name | Olivia Jenai Burlison |
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| Gender | Female |
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| Speciality | Social Worker - Clinical |
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| Location | 2300 Haggerty Rd Ste 2160, West Bloomfield, Michigan |
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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: 1235619222
- Provider Enumeration Date: 08/19/2018
- Last Update Date: 12/19/2023
Medicare PECOS Information:
- PECOS PAC ID: 4688050131
- Enrollment ID: I20221006001028
Medical Identifiers
Medical identifiers for Olivia Jenai Burlison such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1235619222 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 101YM0800X | Counselor - Mental Health | 6801104536 (Michigan) | Secondary |
| 390200000X | Student In An Organized Health Care Education/training Program | (* (Not Available)) | Secondary |
| 1041C0700X | Social Worker - Clinical | 6801110678 (Michigan) | 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. Olivia Jenai Burlison allows following entities to bill medicare on her behalf.
| Entity Name | Henry Ford Health System |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1689732414
PECOS PAC ID: 0547178311
Enrollment ID: O20031210000509 |
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| Entity Name | Henry Ford Health System-school Based Health Initiative |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1104010578
PECOS PAC ID: 3072875517
Enrollment ID: O20180322000407 |
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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. Olivia Jenai Burlison 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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Olivia Jenai Burlison,
3740 Cheryl Dr,
Commerce Township, MI 48382-1719
Ph: (734) 353-6143 | Olivia Jenai Burlison,
2300 Haggerty Rd Ste 2160,
West Bloomfield, MI 48323-2192
Ph: (248) 859-2457 |
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