ALYSSA GUNDERSON (LMSW) – Social Worker, NPI 1780312108

ALYSSA GUNDERSON (LMSW) is a healthcare provider. based in Norton shores, Michigan. specializing in CLINICAL SOCIAL WORKER. They hold the professional credentials LMSW. They hold a License No. 6801111066 (MI). The NPI Number for ALYSSA GUNDERSON (LMSW) is 1780312108

Main info

Female
Sole Proprietor
7 Years Of Experience
Accepts Medicare Assignment
Name
ALYSSA GUNDERSON (LMSW)
NPI
1780312108
Phone
Not provided
Address
3611 HENRY ST
Enumeration Date
12 August 2022
Last Update Date
12 August 2022

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6169529957
Graduation Year
2019 (7 years ago)
PAC ID
7012393572
Group Practice PAC ID
6103238167
Professional Enrollment ID
I20221006001177
Address ID
MI494242905HO400XXAVEX301
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience30
Completeness75
Years active:3State licenses:1Digital endpointsOther names

4,821 CLINICAL SOCIAL WORKER in MI

Provider Addresses for ALYSSA GUNDERSON (LMSW)

  • 3611 HENRY ST

    NORTON SHORES, MI 494414705

    Phone:

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2022-10-06

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20221006001177IClinical Social WorkerMITBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 49441)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 6103238167View full group profile
NameSpecialtyState
Nurse PractitionerMI
Clinical PsychologistMI
Clinical PsychologistMI
Clinical Social WorkerMI
Mental Health CounselorMI
Clinical Social WorkerMI
Clinical Social WorkerIN

Reviews

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Frequently asked questions

How do I look up ALYSSA GUNDERSON (LMSW) by NPI?
Use NPI 1780312108 when you need to reference ALYSSA GUNDERSON (LMSW) in forms, claims, or directories.
Is ALYSSA GUNDERSON (LMSW)'s enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
Can you summarize ALYSSA GUNDERSON (LMSW)'s specialty in plain language?
Clinically, the directory lists ALYSSA GUNDERSON (LMSW) with Social Worker. Clinical services aligned with this taxonomy classification.
Where is ALYSSA GUNDERSON (LMSW)'s primary listing?
We display Norton Shores, Michigan because that is what the record indicates for ALYSSA GUNDERSON (LMSW).
Is ALYSSA GUNDERSON (LMSW) a real provider?
This page reflects official NPPES data for NPI 1780312108. Always confirm identity and privileges with the practice and licensing boards.

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