Individual provider Active NPI

Malinda L Wilson, LMSW

  • Clinical Social Worker
  • Farmington Hills, MI
National Provider Identifier
1235380791
Registry record updated Apr 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801088485 Issued in MI
Practice address
32961 Middlebelt Rd
Farmington Hills, MI 48334-1729
Phone
(248) 855-1540
Fax
(248) 855-2481
NPI assigned
Oct 2, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 29, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X C006175 NC
Clinical Social Worker 1041C0700X 6801088485 MI Primary

Addresses

Primary practice location

32961 Middlebelt Rd
Farmington Hills, MI 48334-1729

Mailing address

2925 Russell St
Detroit, MI 48207-4825

Other practice location 1

2925 Russell St
Detroit, MI 48207-4825
Phone (313) 662-4080

Other identifiers 1

IdentifierTypeStateIssuer
1235380791OtherNPI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801088485MIMDClinical Social Worker
C006175NCMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Emeralds Radiant Life-Style LLC Clinical Current Accepting new patients

Locations

19785 W 12 Mile Rd
Southfield, MI 48076
Phone (313) 687-4455

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": "1222905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777420800000",
    "number": "1235380791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2925 RUSSELL ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482074825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32961 MIDDLEBELT RD",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483341729",
            "telephone_number": "248-855-1540",
            "fax_number": "248-855-2481"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2925 Russell St",
            "address_purpose": "LOCATION",
            "city": "Detroit",
            "state": "MI",
            "postal_code": "482074825",
            "country_code": "US",
            "telephone_number": "313-662-4080",
            "fax_number": "313-662-4080",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILSON",
        "first_name": "MALINDA",
        "middle_name": "L",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-10-02",
        "last_updated": "2026-04-29",
        "certification_date": "2026-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C006175",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801088485",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1235380791",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmington Hills, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 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.