Mikaela Walburg, LMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801119022 Issued in MI

Practice address

416 Plymouth Ave NE
Grand Rapids, MI 49505

Phone

(616) 202-6484

NPI assigned

Nov 13, 2024

Last updated

Jun 14, 2025By 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

Not listed in the public Medicare enrollment file

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.

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Grounded in Growth LLC

  • Clinical Psychologist
  • Grand Rapids, MI
  • NPI 1740914316
  NPD

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

{
    "created_epoch": "1731456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749859200000",
    "number": "1922822279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3528 BALDWIN ST",
            "city": "HUDSONVILLE",
            "state": "MI",
            "postal_code": "494268640",
            "telephone_number": "734-620-7053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "416 PLYMOUTH AVE NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "49505",
            "telephone_number": "616-202-6484"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3528 Baldwin St",
            "address_purpose": "LOCATION",
            "city": "Hudsonville",
            "state": "MI",
            "postal_code": "494268640",
            "country_code": "US",
            "telephone_number": "734-620-7053",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALBURG",
        "first_name": "MIKAELA",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-11-13",
        "last_updated": "2025-06-14",
        "certification_date": "2025-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801119022",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimberli Wakley
• Wal-Mart Stores East LP (Walmart Pharmacy 10-2493)
• Wal-Mart Stores East, LP (Vision Center 30-2493)
• Wal-Mart Stores, Inc. (Vision Center 30-1609)
• Anne Marie Walberer
• Andrea Walcott
• Dawn Renee Walcott, LMSW
• Emily Walcott, CTRS, ATRIC
• Janice Walcott, NP
• Richard Waldmiller

• 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 Jun 14, 2025; 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.