MEDICARE: OLIVE BRANCH HEALING LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1164293585
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OLIVE BRANCH HEALING LLC

Provider Business Mailing Address
First Line	:	204 E CHURCH ST STE 204
Second Line	:
City	:	ADRIAN
State	:	MI
Zip	:	49221-2953
Country	:	US
Telephone Number	:	734-926-8722
Fax Number	:

Provider Business Practice Location Address
First Line	:	204 E CHURCH ST STE 204
Second Line	:
City	:	ADRIAN
State	:	MI
Zip	:	49221-2953
Country	:	US
Telephone Number	:	734-926-8722
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	RACHEL JAWAD-CRALEY
Credential	:	LMSW-C
Telephone Number	:	734-926-8722

Provider Enumeration Date	:	01/15/2024
Last Update Date	:	01/30/2026

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