Individual provider · Type 1 NPI

Marissa Bultsma

Clinical Social Worker · Kentwood, MI

NPI number 1407708969 Active

Practice location

1403 60th St SE
Kentwood, MI 49508-7065

Call (616) 485-9561 Map

Mailing address

5910 Kiverton Ridge Dr SE
Kentwood, MI 49508-2312

Specialties and licenses

TaxonomyCodeLicense
Clinical Social Worker Primary 1041C0700X6801115146 (MI)

Clinical Social Worker: A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpers…

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About NPI 1407708969

Marissa Bultsma's National Provider Identifier is 1407708969, issued on Feb 9, 2026. The primary taxonomy on file is Clinical Social Worker (1041C0700X), and the practice location is in Kentwood, MI. The record was last updated on Feb 9, 2026.