Kaissidy Homolka, LMSW
Individual provider Active NPI Clinical Social Worker · Mio, MI
NPI 1063370385 · NPPES record last updated Jan 19, 2026
Key facts
- NPI
- 1063370385
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 6851121350 (MI)
- Practice address
- 1110 W 8TH St
Mio, MI 48647-9140 - Phone
- (989) 354-2197
- Fax
- (989) 354-1952
- NPI assigned
- Jan 14, 2026
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6851121350 | MI | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Thunder Bay Community Health Service, Inc | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 6851121350 | MI | Yes |
| Social Worker | 104100000X |
Addresses
Primary practice location
1110 W 8TH St
Mio, MI 48647-9140
Mailing address
PO Box 427
Hillman, MI 49746-0427
Phone (989) 354-2197
Other providers in Mio, MI
- Linda Esch
- Every Little Piece Counseling PLLC
- Family Fitness and Rehabilitation, LLC
- Richard Daniel Graebner
- Melanie Green
- Kimberly Sue Hunter
- Lisa Ann Joy
- Rebecca Lynn Kalbfleisch
- Terrence Lee Krumbach
- Justin Kuhns
All providers in Mio, MI · Clinical Social Worker in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 19, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.