SERINA J VANDERBUSH (LMSW) – Clinical Social Worker, NPI 1205497088

SERINA J VANDERBUSH (LMSW) is a healthcare provider. based in Temperance, Michigan. specializing in CLINICAL SOCIAL WORKER. They hold the professional credentials LMSW. They hold a License No. 6801104896 (MI). The NPI Number for SERINA J VANDERBUSH (LMSW) is 1205497088

Main info

Female
7 Years Of Experience
Accepts Medicare Assignment
Name
SERINA J VANDERBUSH (LMSW)
NPI
1205497088
Phone
(734) 850-6903
Address
8765 LEWIS AVE
Enumeration Date
24 June 2019
Last Update Date
13 October 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7348473802
Graduation Year
2019 (7 years ago)
PAC ID
0547621427
Group Practice PAC ID
2769575653
Professional Enrollment ID
I20230726000654
Address ID
MI481829583TE8765XAVEX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience40
Completeness85
Years active:6State licenses:2Digital endpointsOther names

4,821 CLINICAL SOCIAL WORKER in MI

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Provider Addresses for SERINA J VANDERBUSH (LMSW)

  • Family Medical Center of Michigan, 8765, Lewis Avenue, Temperance, Bedford Township, Monroe County, Michigan, 48182, United States

    TEMPERANCE, MI 481829583

    Phone: (734) 850-6903

    Fax: (734) 850-0520

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2023-07-26

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20230726000654IClinical Social WorkerMITBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 48182)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 2769575653View full group profile
NameSpecialtyState
-MI
Family PracticeMI
Clinical Social WorkerMI
Nurse PractitionerHI
Clinical Social WorkerMI
Physician AssistantMI
Family PracticeOH
Family PracticeOH
Family PracticeMI
Mental Health CounselorMI

Reviews

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Frequently asked questions

Does SERINA J VANDERBUSH (LMSW) share an NPI with anyone else?
NPI numbers are unique to each provider or organization — SERINA J VANDERBUSH (LMSW) uses 1205497088.
Can I rely on SERINA J VANDERBUSH (LMSW) being an active provider?
As of the registry snapshot, SERINA J VANDERBUSH (LMSW) is marked active.
What taxonomy line describes SERINA J VANDERBUSH (LMSW)?
For research purposes, treat SERINA J VANDERBUSH (LMSW) as Clinical Social Worker in this dataset. Clinical services aligned with this taxonomy classification.
Where should I expect SERINA J VANDERBUSH (LMSW) on a map?
Expect Temperance, Michigan as a primary anchor for SERINA J VANDERBUSH (LMSW) unless the record lists multiple sites.
Why does SERINA J VANDERBUSH (LMSW) have multiple addresses?
2 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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