Individual provider Active NPI

Kathleen Mary Huber

  • Clinical Social Worker
  • Marysville, MI
National Provider Identifier
1003464751
Registry record updated Apr 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
1358 Pennsylvania Ave
Marysville, MI 48040-1446
Phone
(810) 414-0714
NPI assigned
Aug 27, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 30, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X Primary

Addresses

Primary practice location

1358 Pennsylvania Ave
Marysville, MI 48040-1446

Mailing address

1358 Pennsylvania Ave
Marysville, MI 48040-1446
Phone (810) 414-0714

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200916001926 MI Practitioner - Clinical Social Worker 2062830417 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Michigan State University College of Human Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pure Psychiatry of Michigan PLLCGroup PAC ID 1254741283, 102 clinicians

Practice addresses (Care Compare)

3031 Commerce Dr
Suite a
Fort Gratiot, MI 48059-4515
Phone (810) 292-0557

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Pure Psychiatry of Michigan PLLC CurrentSince Mar 9, 2026 Accepting new patients
Millie a. Paterson, PLLC Clinical CurrentSince Sep 1, 2020 Accepting new patients
Lakeshore Therapy PLLC Clinical PastSince Sep 1, 2020 Accepting new patients

Locations

3031 Commerce Dr
Ste A
Fort Gratiot, MI 48059
Phone (810) 292-0557

5730 Main St
Lexington, MI 48450
Phone (810) 359-2605

119 E Sanilac Rd
Ste 8
Sandusky, MI 48471
Phone (810) 689-4760

650 E Big Beaver Rd
Ste C
Troy, MI 48083
Phone (248) 781-8921

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1566864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745971200000",
    "number": "1003464751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1358 PENNSYLVANIA AVE",
            "city": "MARYSVILLE",
            "state": "MI",
            "postal_code": "480401446",
            "telephone_number": "810-414-0714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1358 PENNSYLVANIA AVE",
            "city": "MARYSVILLE",
            "state": "MI",
            "postal_code": "480401446",
            "telephone_number": "810-414-0714"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUBER",
        "first_name": "KATHLEEN",
        "middle_name": "MARY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-08-27",
        "last_updated": "2025-04-30",
        "certification_date": "2025-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marysville, MI

Sources for this page

Verify at the official NPI Registry.