Tasha Bourne, LMSW is a
Social Worker - Clinical based in Grandville, Michigan. Tasha Bourne is licensed to practice in Michigan (license number 6801094573) and her current practice location is
6105 Wilson Ave Sw Ste 204, Grandville, Michigan. She can be reached at her office (for appointments etc.) via phone at
(616) 486-5421.
NPI number for Tasha Bourne is 1164780888 and her current mailing address is 100 Michigan St Ne # Mc845, Grand Rapids, Michigan. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1164780888.
Healthcare Provider's Profile
Full Name | Tasha Bourne |
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Gender | Female |
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Speciality | Social Worker - Clinical |
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Location | 6105 Wilson Ave Sw Ste 204, Grandville, Michigan |
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Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
NPI Data:
- NPI Number: 1164780888
- Provider Enumeration Date: 05/01/2012
- Last Update Date: 01/07/2019
Medical Identifiers
Medical identifiers for Tasha Bourne such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1164780888 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Secondary |
1041C0700X | Social Worker - Clinical | 6801094573 (Michigan) | Primary |
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. Tasha Bourne is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Tasha Bourne, LMSW 100 Michigan St Ne # Mc845, Grand Rapids, MI 49503-2560 Ph: () - | Tasha Bourne, LMSW 6105 Wilson Ave Sw Ste 204, Grandville, MI 49418-9714 Ph: (616) 486-5421 |
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