Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Marissa Bultsma

Individual provider Clinical Social Worker · NPI 1407708969

Marissa Bultsma is a Clinical Social Worker in Kentwood, Michigan. Qualified in 2020, 6 years ago. Licensed in Michigan.

Years since qualifying
6
Licensed in
MI
In the registry since
2026
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Practice location Address checks out

1403 60th St SE
Kentwood, MI 49508-7065
Phone: (616) 485-9561
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 6801115146 (MI)

Record details

NPI number1407708969
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedFebruary 9, 2026
Last updated in NPPESFebruary 9, 2026
Certification dateFebruary 9, 2026
Mailing address5910 Kiverton Ridge Dr Se, Kentwood, MI 49508-2312

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

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