Marissa Michalke, LICSW, SUDP

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LW60804511 Issued in WA

Practice address

4411 Point Fosdick Dr Ste 307
Gig Harbor, WA 98335-1703

Phone

(253) 851-3808

Fax

(253) 851-3188

NPI assigned

Jul 10, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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.

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1404950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715472000000",
    "number": "1366858219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4411 POINT FOSDICK DR STE 307",
            "city": "GIG HARBOR",
            "state": "WA",
            "postal_code": "983351703",
            "telephone_number": "253-886-1366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4411 POINT FOSDICK DR STE 307",
            "city": "GIG HARBOR",
            "state": "WA",
            "postal_code": "983351703",
            "telephone_number": "253-851-3808",
            "fax_number": "253-851-3188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICHALKE",
        "first_name": "MARISSA",
        "credential": "LICSW, SUDP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-10",
        "last_updated": "2024-05-12",
        "certification_date": "2024-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WA",
            "license": "CP60684686",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "LW60804511",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• MH Wellness & Acupuncture Studio
• Michael Flatley DDS PS
• Michael J Neish DMD PLLC
• Catherine Ann Michael, OTR/L
• Sharon Michael, M.D.
• Tamara Mickelson, PA-C
• Tamatha Raylene Mikes, PHARMD
• Diana Miller, L.C.S.W.
• Erin Margaret Miller
• Lisa Ann Miller, CCC-SLP

• Clinical Social Worker in Gig Harbor, WA
• Providers in Gig Harbor, WA by specialty
• Clinical Social Worker in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2024; 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.