Derek Witzke, LLMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801123020 Issued in MI

Practice address

805 S Carmel St
Cadillac, MI 49601-2344

Phone

(231) 775-6517

NPI assigned

Aug 24, 2023

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Lifeskills Psychological Services PC

  • Counseling Psychologist
  • Cadillac, MI
  • NPI 1104983923
  NPD (past)

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

{
    "created_epoch": "1692835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788998400000",
    "number": "1104600626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5190 E 32 RD",
            "city": "CADILLAC",
            "state": "MI",
            "postal_code": "496019006",
            "telephone_number": "231-878-7523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "805 S CARMEL ST",
            "city": "CADILLAC",
            "state": "MI",
            "postal_code": "496012344",
            "telephone_number": "231-775-6517"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5190 E 32 Rd",
            "address_purpose": "LOCATION",
            "city": "Cadillac",
            "state": "MI",
            "postal_code": "496019006",
            "country_code": "US",
            "telephone_number": "231-878-7523",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WITZKE",
        "first_name": "DEREK",
        "credential": "LLMSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-08-24",
        "last_updated": "2026-09-10",
        "certification_date": "2026-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801123020",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebecca Wing
• Tricia Wing, PT, DPT
• Kamren James Winrick
• Monica Witkowski, RBT
• Walter J Witkowski, PT
• Pamela L Wizner-Randazzo, MA, LPC, CAADC
• Women'S Health Specialists, P.C.
• William Woodward
• Kristina Rose Woodworth
• Beth Ann Woolston, LBSW

• Clinical Social Worker in Cadillac, MI
• Providers in Cadillac, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.