MACKENZIE BULLERJAHN LCSW
NPI 1528852464
Social Worker - Clinical in Grand Forks, ND

Q: What is Mackenzie Bullerjahn's NPI number?

The NPI number for Mackenzie Bullerjahn is 1528852464. It was assigned to this individual provider in the NPPES registry on April 7, 2025.

Q: What is Mackenzie Bullerjahn's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Active since April 07, 2025PECOS EnrolledAccepts Medicare Assignment

3674 S WASHINGTON ST, GRAND FORKS, ND 58201(701) 732-2538(701) 732-2501 Get Directions Write a Review

NPPES record last updated: January 22, 2026. Verified against the NPPES registry weekly; last sync: November 08, 2026.

Record update history: Jan 22, 2026, Apr 7, 2025 (2 updates tracked since 2025).

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About Mackenzie Bullerjahn Lcsw NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MACKENZIE BULLERJAHN LCSW (NPI 1528852464) is an individual clinical provider in Grand Forks, North Dakota, licensed in New Jersey (44SC06185700) and active in the NPI registry since April 2025. She is enrolled in Medicare PECOS and is a graduate of Other (2017).

NPPES Registry Identity

NPI1528852464

Entity TypeIndividualFemale

Primary Taxonomy1041C0700X

Provider Legal NameMACKENZIE BULLERJAHNCredential: LCSW

Location Address3674 S WASHINGTON STGrand Forks, ND 58201-5766

Mailing AddressPo Box 5210Grand Forks, ND 58206-5210 · (701) 205-3000 · Fax (701) 732-2501

Phone(701) 732-2538

Fax(701) 732-2501

Sole ProprietorNo

Medical School CMSOtherGraduated 2017

Enumeration DateApril 7, 2025

Last NPPES UpdateJanuary 22, 20262 updates tracked since enumeration

NPPES CertifiedJanuary 22, 2026

✔ NPI 1528852464 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers

Taxonomy Code1041C0700X

License✔ Licensed in NJ · 44SC06185700

Definition

A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.

3674 S WASHINGTON ST, Grand Forks, ND 58201

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Montana, Blue Cross Blue Shield of North Dakota, HealthPartners and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Mackenzie Bullerjahn Lcsw is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID1254842131

PECOS Enrollment IDI20250617003402, I20250721000987, I20250814004449, I20251006001000

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

Medicare enrollment records show Mackenzie Bullerjahn reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Peterson Medical Clinics, LLC

Same address

Multi-Specialty

3674 S WASHINGTON ST
Grand Forks, ND 58201

Reassigned Medicare billing, Alaska, Minnesota, Montana and North Dakota enrollments
70 clinicians in this Medicare group

NPI 1699295774 (701) 205-3000

Cowlitz Indian Tribe

1,217 mi

Rehabilitation, Substance Use Disorder

7105 NE 40TH ST
Vancouver, WA 98661

Reassigned Medicare billing, Texas enrollment
Medicare enrollment name: Bristol Bay Area Health Corporation
360 clinicians in this Medicare group

NPI 1538412630 (360) 353-9431

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 58201 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$0.00 typical visit price

range $55.75 – $168.12

Typical copayment $0.00 (range $13.93 – $42.03)

Most-billed visit code NA

Established Patient

$69.48 typical visit price

range $18.11 – $137.65

Typical copayment $17.37 (range $4.52 – $34.41)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SHERBIE DARBOUZE PA-C

Physician Assistant