Kimberly Lynn Whittaker, LMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801114800 Issued in MI

Practice address

300 68TH St SE
Grand Rapids, MI 49548-6927

Phone

(616) 559-5896

NPI assigned

May 9, 2023

Last updated

Jul 23, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

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.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Pine Rest Christian Mental Health Services

  • Social Worker
  • Grand Rapids, MI
  • NPI 1922019157
  Medicare reassignment NPD
• Western Michigan University

  • Health Service Clinic/Center
  • Kalamazoo, MI
  • NPI 1467470492
  Medicare reassignment NPD
• Pine Rest Christian Mental Health Services

  • Professional Counselor
  • Grand Rapids, MI
  • NPI 1386015683
  NPD
• Western Michigan University Unified Clinics

  dba Unified Clinics

  • Multi-Specialty Clinic/Center
  • Kalamazoo, MI
  • NPI 1538340567
  NPD
• Great Lakes Recovery Centers

  • Children's Substance Abuse Rehabilitation Facility
  • Negaunee, MI
  • NPI 1669899241
  NPD (past)
• Great Lakes Recovery Centers

  • Substance Abuse Rehabilitation Facility
  • Ironwood, MI
  • NPI 1821267956
  NPD (past)

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

{
    "created_epoch": "1683590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721692800000",
    "number": "1538859020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 68TH ST SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495486927"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 68TH ST SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495486927",
            "telephone_number": "616-559-5896"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1115 S Hemlock St Ste 1",
            "address_purpose": "LOCATION",
            "city": "Iron Mountain",
            "state": "MI",
            "postal_code": "498013800",
            "country_code": "US",
            "telephone_number": "906-774-2561",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "104 Malton Rd",
            "address_purpose": "LOCATION",
            "city": "Negaunee",
            "state": "MI",
            "postal_code": "498662000",
            "country_code": "US",
            "telephone_number": "906-228-4692",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WHITTAKER",
        "first_name": "KIMBERLY",
        "middle_name": "LYNN",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-05-09",
        "last_updated": "2024-07-23",
        "certification_date": "2024-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801114800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Natalie Claire Whitmer
• Melodie Whitmore, LLPC
• Lyla Whitney
• Sarah Whitney, LLMSW
• Brent G Whittaker, MD
• Philip Eugene Whitten II, LLMSW
• Erica Whittenberger, MD
• Esther Wilhelmina Whitters
• Claire Whittle, PA-C
• Whole Self Counseling GR LLC

• Clinical Social Worker in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 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.