Laura Meeker Wicksall, LMSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

6801095775 Issued in MI

Practice address

1430 Robinson Rd SE Ste 206
Grand Rapids, MI 49506-1723

Phone

(231) 499-1063

NPI assigned

Jun 11, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Laura Meeker Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1402444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522713600000",
    "number": "1710390372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1430 ROBINSON RD SE STE 206",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495061723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1430 ROBINSON RD SE STE 206",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495061723",
            "telephone_number": "231-499-1063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WICKSALL",
        "first_name": "LAURA",
        "middle_name": "MEEKER",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-11",
        "last_updated": "2018-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MI",
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6801095775",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAURA",
            "last_name": "MEEKER",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Melissa Wichterman
• Carrie Elizabeth Wicklund, LMSW
• Daniel Francis Wicklund, DNP
• Benjamin Paul Wickman
• Andrew Benjamin Wicks, PT, DPT
• Michel Marie Wicksall, DDS
• Thomas J Wickstrom, RPH
• Ashley Nicole Widdis, RD
• Erin E Wieczorek, LMSW
• James Louis Wieland, D.D.S.

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2018; 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.