Individual provider Active NPI

Erich Lichtenwalter, LMSW

  • Clinical Social Worker
  • Benton Harbor, MI
National Provider Identifier
1780439653
Registry record updated Mar 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801119795 Issued in MI
Practice address
133 W Main St
Benton Harbor, MI 49022-3607
Phone
(269) 408-2258
Fax
(989) 352-6435
NPI assigned
Apr 23, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 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 6801119795 MI Primary

Addresses

Primary practice location

133 W Main St
Benton Harbor, MI 49022-3607

Mailing address

4709 Timberland Dr
Berrien Springs, MI 49103-1430
Phone (269) 861-4287

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250503000014 MI Practitioner - Clinical Social Worker 6406373430 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Life Coach Psychology PLCGroup PAC ID 9133304744, 11 clinicians

Practice addresses (Care Compare)

300 W Ferry St
Berrien Springs, MI 49103-1109
Phone (269) 815-5331

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Life Coach Psychology PLC CurrentSince Apr 1, 2025 Accepting new patients
Life Coach Psychology PLC CurrentSince Apr 1, 2025 Accepting new patients

Locations

300 W Ferry St
Berrien Springs, MI 49103
Phone (269) 815-5331

2775 W Dickman Rd
Ste P1
Springfield, MI 49037
Phone (269) 883-6560

Organizations & group practices 2

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": "1713830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740787200000",
    "number": "1780439653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4709 TIMBERLAND DR",
            "city": "BERRIEN SPRINGS",
            "state": "MI",
            "postal_code": "491031430",
            "telephone_number": "269-861-4287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "133 W MAIN ST",
            "city": "BENTON HARBOR",
            "state": "MI",
            "postal_code": "490223607",
            "telephone_number": "269-408-2258",
            "fax_number": "989-352-6435"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LICHTENWALTER",
        "first_name": "ERICH",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-04-23",
        "last_updated": "2025-03-01",
        "certification_date": "2025-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801119795",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Benton Harbor, MI

Sources for this page

Verify at the official NPI Registry.