Individual provider Active NPI

Eneziah Walters

  • Clinical Social Worker
  • Lansing, MI
National Provider Identifier
1194383802
Registry record updated Jun 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801108006 Issued in MI
Practice address
616 S Creyts Rd Ste D
Lansing, MI 48917-8269
Phone
(517) 512-5289
NPI assigned
May 29, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 3, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 6801102859 MI
Social Worker 104100000X 6801108006 MI
Clinical Social Worker 1041C0700X 6801108006 MI Primary

Addresses

Primary practice location

616 S Creyts Rd Ste D
Lansing, MI 48917-8269

Mailing address

134 W Maple St
Mason, MI 48854-1657
Phone (517) 676-9788

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
I20201030001250 MI Practitioner - Clinical Social Worker 0749690840 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2018
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2111 University Park Dr
Suite 400
Okemos, MI 48864-6907

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801102859MIMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Eneziah Walters LCSW LLC Social Worker CurrentSince Jun 1, 2022 Accepting new patients
Community Mental Health Authority of Clinton Eaton Ingham Counties PastSince Mar 1, 2011 Accepting new patients

Locations

616 S Creyts Rd
Ste D
Lansing, MI 48917
Phone (517) 258-1272

134 W Maple St
Mason, MI 48854
Phone (517) 676-9788

2111 University Park Dr
Ste 400
Okemos, MI 48864
Phone (517) 575-7823

Organizations & group practices 2

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": "1559088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780444800000",
    "number": "1194383802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "134 W MAPLE ST",
            "city": "MASON",
            "state": "MI",
            "postal_code": "488541657",
            "telephone_number": "517-676-9788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "616 S CREYTS RD STE D",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489178269",
            "telephone_number": "517-512-5289"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALTERS",
        "first_name": "ENEZIAH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-05-29",
        "last_updated": "2026-06-03",
        "certification_date": "2026-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6801102859",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6801108006",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801108006",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lansing, MI

Sources for this page

Verify at the official NPI Registry.