Individual provider Active NPI

Natishia Raylynne Ledesma, MSW

  • Clinical Social Worker
  • Portage, MI
National Provider Identifier
1851189245
Registry record updated Apr 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801119817 Issued in MI
Practice address
3546 Fleetwood Dr
Portage, MI 49024-5506
Phone
(269) 377-2615
NPI assigned
Apr 28, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 28, 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 6801119817 MI Primary

Addresses

Primary practice location

3546 Fleetwood Dr
Portage, MI 49024-5506

Mailing address

3546 Fleetwood Dr
Portage, MI 49024-5506
Phone (269) 377-2615

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
I20260311000919 MI Practitioner - Clinical Social Worker 1850874520 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bridge to Restoration Therapy ServicesGroup PAC ID 0244711281, 2 clinicians

Practice addresses (Care Compare)

2920 Fuller Ave NE
Suite 208
Grand Rapids, MI 49505-3458
Phone (616) 551-2916

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801119817MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Bridge to Restoration Therapy Services Clinical CurrentSince Feb 4, 2026 Accepting new patients

Locations

2920 Fuller Ave NE
Ste 208
Grand Rapids, MI 49505
Phone (616) 551-2916

2920 Fuller Ave NE
Ste 110
Grand Rapids, MI 49505

Organizations & group practices 1

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": "1745798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745798400000",
    "number": "1851189245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3546 FLEETWOOD DR",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "490245506",
            "telephone_number": "269-377-2615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3546 FLEETWOOD DR",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "490245506",
            "telephone_number": "269-377-2615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEDESMA",
        "first_name": "NATISHIA",
        "middle_name": "RAYLYNNE",
        "credential": "MSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-04-28",
        "last_updated": "2025-04-28",
        "certification_date": "2025-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801119817",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portage, MI

Sources for this page

Verify at the official NPI Registry.