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

Individual provider Clinical Social Worker · NPI 1104654185

Tamia Waller, LLMSW is a Clinical Social Worker in Plymouth, Michigan. Qualified in 2023, 3 years ago. Practices with Simply Mindful Counseling LLC, a 12-clinician group and accepts Medicare assignment. Licensed in Michigan.

Years since qualifying
3
Licensed in
MI
In the registry since
2024
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Practice location Address checks out

340 N Main St Ste 200
Plymouth, MI 48170-1250
Phone: (734) 335-0028
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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 6801121073 (MI)

Record details

NPI number1104654185
Entity typeIndividual (Type 1)
GenderFemale
Credentials LLMSW
Sole proprietorNo
NPI enumeratedJuly 23, 2024
Last updated in NPPESJanuary 26, 2026
Certification dateJanuary 26, 2026
Mailing address340 N Main St Ste 200, Plymouth, MI 48170-1250

Medicare enrollment

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

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Group practice Simply Mindful Counseling Llc — 12 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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