Healthcare Provider Details

I. General information

NPI: 1184381725
Provider Name (Legal Business Name): CAITLIN ELIZABETH JIMERSON LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/18/2021
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

493 W NORTON AVE
NORTON SHORES MI
49444-3748
US

IV. Provider business mailing address

3217 LEON ST
NORTON SHORES MI
49441-3616
US

V. Phone/Fax

Practice location:
  • Phone: 616-319-4389
  • Fax:
Mailing address:
  • Phone: 231-580-1200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number6801122906
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: