Healthcare Provider Details

I. General information

NPI: 1104041466
Provider Name (Legal Business Name): JAMES ROBERT WALAINIS MSW, LMSW, BCD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/13/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 WILSHIRE DR SUITE 202
TROY MI
48084-1634
US

IV. Provider business mailing address

3361 SQUIRREL RD
BLOOMFIELD HILLS MI
48304-2456
US

V. Phone/Fax

Practice location:
  • Phone: 248-765-4041
  • Fax:
Mailing address:
  • Phone: 248-765-4041
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6801012171
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number4101005944
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: