Individual provider Active NPI

Michael Towns-Wheatley, LMSW

  • Clinical Social Worker
  • Grand Rapids, MI
National Provider Identifier
1316445422
Registry record updated Aug 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801114537 Issued in MI
Practice address
790 Fuller Ave NE
Grand Rapids, MI 49503-1918
Phone
(616) 336-3909
Fax
(616) 336-8830
NPI assigned
Jan 24, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2024

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 0904014339 VA
Clinical Social Worker 1041C0700X 6801114537 MI Primary

Addresses

Primary practice location

790 Fuller Ave NE
Grand Rapids, MI 49503-1918

Mailing address

2180 Banner Dr SW
Wyoming, MI 49509-1924
Phone (997) 526-9993

Other practice location 1

4850 Mark Center Dr
Alexandria, VA 22311-1882
Phone (703) 746-3400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801114537MIMDClinical Social Worker
0904014339VAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Inova Health Care Services CurrentSince Aug 12, 2024 Accepting new patients
Inova Health Care Services CurrentSince Aug 12, 2024 Accepting new patients
Interact of Michigan, Inc PastSince Aug 13, 2019 Accepting new patients

Locations

8505 Arlington Blvd
Ste 200
Fairfax, VA 22031
Phone (703) 698-8525

224B Cornwall St NW
Leesburg, VA 20176
Phone (703) 771-2894

44045 Riverside Pkwy
Leesburg, VA 20176
Phone (703) 858-6040

Organizations & group practices 3

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": "1516752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724630400000",
    "number": "1316445422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2180 BANNER DR SW",
            "city": "WYOMING",
            "state": "MI",
            "postal_code": "495091924",
            "telephone_number": "997-526-9993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "790 FULLER AVE NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495031918",
            "telephone_number": "616-336-3909",
            "fax_number": "616-336-8830"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4850 Mark Center Dr",
            "address_purpose": "LOCATION",
            "city": "Alexandria",
            "state": "VA",
            "postal_code": "223111882",
            "country_code": "US",
            "telephone_number": "703-746-3400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TOWNS-WHEATLEY",
        "first_name": "MICHAEL",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-01-24",
        "last_updated": "2024-08-26",
        "certification_date": "2024-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904014339",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801114537",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.