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MARISSA BULTSMA
NPI 1407708969
Social Worker - Clinical in Kentwood, MI

Active since February 09, 2026PECOS Enrolled
1403 60TH ST SE, KENTWOOD, MI 49508(616) 485-9561 Get Directions Write a Review

NPPES record last updated: February 9, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Marissa Bultsma NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MARISSA BULTSMA (NPI 1407708969) is an individual clinical provider in Kentwood, Michigan, licensed in Michigan (6801115146) and active in the NPI registry since February 2026. She is enrolled in Medicare PECOS and is a graduate of Other (2020).

NPPES Registry Identity

NPI1407708969
Entity TypeIndividualFemale
Primary Taxonomy1041C0700X
Provider Legal NameMARISSA BULTSMA
Location Address1403 60TH ST SEKentwood, MI 49508-7065
Mailing Address5910 Kiverton Ridge Dr SeKentwood, MI 49508-2312 · (616) 485-9561
Phone(616) 485-9561
Sole ProprietorNo
Medical School CMSOtherGraduated 2020
Enumeration DateFebruary 9, 2026
NPPES CertifiedFebruary 9, 2026
✔ NPI 1407708969 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
License✔ Licensed in MI · 6801115146
Definition
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 interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
1403 60TH ST SE, Kentwood, MI 49508
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Marissa Bultsma is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID3577044841
PECOS Enrollment IDI20260225000739
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 49508 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$0.00 typical visit price
range $54.34 – $166.68
Typical copayment $0.00 (range $13.58 – $41.67)
Most-billed visit code NA
Established Patient
$68.07 typical visit price
range $17.09 – $135.40
Typical copayment $17.01 (range $4.27 – $33.85)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 11

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

PHILIP S FOX MD
Psychiatry & Neurology (Psychiatry)
1403 60TH ST SE
KENTWOOD, MI 49508
Kent County (616) 719-4488
JOSHUA COLBY M.A, LPC, CAADC
Counselor (Professional)
1403 60TH ST SE
KENTWOOD, MI 49508
Kent County (616) 805-3660
DR. RANDALL M CHRISTENSON MD
Psychiatry & Neurology (Geriatric Psychiatry)
1403 60TH ST SE
KENTWOOD, MI 49508
Kent County (616) 719-4488
MRS. NICOLE LYNN MICK LMSW
Social Worker (Clinical)
1403 60TH ST SE
KENTWOOD, MI 49508
Kent County (616) 805-3660
ANANYA AVINASH LMSW
Social Worker (Clinical)
1403 60TH ST SE
GRAND RAPIDS, MI 49508
Kent County (616) 805-3660
MR. BRIAN KEN FUJII LPC, MAC, NCC
Counselor (Professional)
1403 60TH ST SE
GRAND RAPIDS, MI 49508
Kent County (616) 805-3360
CARMELITA YOUNG
Counselor (Professional)
1403 60TH ST SE
GRAND RAPIDS, MI 49508
Kent County (616) 805-3660
RHIANNON WHITE-SCHRAMSKI LMSW
Social Worker (Clinical)
1403 60TH ST SE
KENTWOOD, MI 49508
Kent County (616) 805-3660

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Marissa Bultsma's NPI number?

The NPI number for Marissa Bultsma is 1407708969. It was assigned to this individual provider in the NPPES registry on February 9, 2026.

Where is Marissa Bultsma located?

Marissa Bultsma practices at 1403 60th St SE, Kentwood, MI 49508. The listed phone number is (616) 485-9561.

What is Marissa Bultsma's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Is Marissa Bultsma enrolled in Medicare?

Yes. Marissa Bultsma is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Marissa Bultsma was last updated on February 9, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.