Kimberly Thullen

Primary specialty

Social WorkerTaxonomy code 104100000X

License

6851119928 Issued in MI

Practice address

901 W Mem Dr
Houghton, MI 49931-2492

Phone

(906) 482-9404

NPI assigned

Jan 26, 2026

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Kimberly Walters Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1769385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769385600000",
    "number": "1205785987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 W MEM DR",
            "city": "HOUGHTON",
            "state": "MI",
            "postal_code": "499312492",
            "telephone_number": "906-482-9404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 W MEM DR",
            "city": "HOUGHTON",
            "state": "MI",
            "postal_code": "499312492",
            "telephone_number": "906-482-9404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THULLEN",
        "first_name": "KIMBERLY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-01-26",
        "last_updated": "2026-01-26",
        "certification_date": "2026-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6802092622",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6851119928",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "WALTERS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jane Summersett, DDS
• Corin S Swartz, PT
• Adam Tedeschi, PHARMD
• Korinne Anna Umlauft Thomas, MSAT, LAT, ATC
• Carrie Ann Thompson, RN
• Abby Nichole Tienhaara, RN
• Douglas P Tozier
• Julie Tufte, LMT, CCHT, RM/T
• Brittany Lynn Turner
• Unite Up

• Social Worker in Houghton, MI
• Providers in Houghton, MI by specialty
• Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.