Individual provider Active NPI

Rachael Wall, LLMSW

  • Clinical Social Worker
  • Warren, MI
National Provider Identifier
1548030067
Registry record updated Jul 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6851118859 Issued in MI
Practice address
11480 E 13 Mile Rd
Warren, MI 48093-2566
Phone
(586) 216-9253
NPI assigned
Jan 5, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 6851118859 MI Primary

Addresses

Primary practice location

11480 E 13 Mile Rd
Warren, MI 48093-2566

Mailing address

29080 Michigan Ave
Leonidas, MI 49066-9711
Phone (269) 816-1342

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
6851118859MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Branch Hillsdale St Joseph Community Health Agency CurrentSince Oct 12, 2025 Accepting new patients
Branch-St Joseph Area Agency on Aging CurrentSince Jan 1, 2024 Accepting new patients
International Therapy Solutions, PLLC Clinical CurrentSince Jul 13, 2025 Accepting new patients

Locations

570 Marshall Rd
Coldwater, MI 49036
Phone (517) 278-2538

11480 E 13 Mile Rd
Warren, MI 48093
Phone (586) 216-9253

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": "1704412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751846400000",
    "number": "1548030067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29080 MICHIGAN AVE",
            "city": "LEONIDAS",
            "state": "MI",
            "postal_code": "490669711",
            "telephone_number": "269-816-1342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11480 E 13 MILE RD",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480932566",
            "telephone_number": "586-216-9253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALL",
        "first_name": "RACHAEL",
        "credential": "LLMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-05",
        "last_updated": "2025-07-07",
        "certification_date": "2025-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6851118859",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warren, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2025; 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.