Individual provider Active NPI

Mikayla Nicole Hershberger, LMSW

  • Clinical Social Worker
  • Hartland, MI
National Provider Identifier
1073124566
Registry record updated Jan 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801119358 Issued in MI
Practice address
11750 Highland Rd Ste 140
Hartland, MI 48353-2729
Phone
(810) 746-9091
Fax
(248) 916-9069
NPI assigned
Aug 10, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 6801119358 MI Primary

Addresses

Primary practice location

11750 Highland Rd Ste 140
Hartland, MI 48353-2729

Mailing address

11750 Highland Rd Ste 140
Hartland, MI 48353-2729
Phone (810) 746-9091

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250121001006 MI Practitioner - Clinical Social Worker 1254860257 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801119358MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Hartland Individual and Family Services LLC CurrentSince Jan 17, 2025 Accepting new patients

Locations

11750 Highland Rd
Ste 140
Hartland, MI 48353
Phone (248) 709-2109

11202 Highland Rd
Hartland, MI 48353
Phone (810) 279-0537

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1597017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737072000000",
    "number": "1073124566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11750 HIGHLAND RD STE 140",
            "city": "HARTLAND",
            "state": "MI",
            "postal_code": "483532729",
            "telephone_number": "810-746-9091",
            "fax_number": "248-916-9069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11750 HIGHLAND RD STE 140",
            "city": "HARTLAND",
            "state": "MI",
            "postal_code": "483532729",
            "telephone_number": "810-746-9091",
            "fax_number": "248-916-9069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERSHBERGER",
        "first_name": "MIKAYLA",
        "middle_name": "NICOLE",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-10",
        "last_updated": "2025-01-17",
        "certification_date": "2025-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801119358",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hartland, MI

Sources for this page

Verify at the official NPI Registry.