Mackenzie Bullerjahn, LCSW
NPI 1528852464ActiveIndividual· Social Worker, Clinical· Grand Forks, ND
Social Worker, Clinical (LCSW) with Peterson Medical Clinics LLC, practicing in Grand Forks, North Dakota. Enrolled in Medicare as practitioner - clinical social worker and practitioner - clinical social worker.
Overview
| NPI | 1528852464 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | LCSW |
| Sole proprietor | No |
| NPI issued | Apr 7, 2025 |
| Last updated in NPPES | Jan 22, 2026 |
| Certified by provider | Jan 22, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Social Worker, Clinical Primary | 1041C0700X | 44SC06185700 | NJ |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Clinical Social Worker (AK); Practitioner - Clinical Social Worker (MN); Practitioner - Clinical Social Worker (MT); Practitioner - Clinical Social Worker (ND); Practitioner - Clinical Social Worker (NJ); Practitioner - Clinical Social Worker (TX) |
|---|
Education and affiliations
| Graduation year | 2017 |
|---|---|
| Medicare specialty | Clinical Social Worker |
| Telehealth | Offers telehealth |
Medical group
- Peterson Medical Clinics LLCAnchorage, AK · 94 clinicians
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