Donovan Khamoro, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801117401 Issued in MI

Practice address

53435 Grand River Ave
New Hudson, MI 48165-8521

Phone

(517) 882-3732

NPI assigned

Oct 5, 2021

Last updated

Dec 3, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Clinical Social Worker

Education

University of Michigan Medical School, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Downriver Mental Health Clinic PCGroup PAC ID 7911995139, 289 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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

• Downriver Mental Health Clinic PC

  dba Lifestance Health, Inc

  • Psychologist
  • Taylor, MI
  • NPI 1295866135

  Mental Health

  Medicare reassignment Care Compare group NPD
• Blue Water Healing Clinic LLC

  • Professional Counselor
  • Jackson, MI
  • NPI 1861284267
  Medicare reassignment
• Downriver Mental Health Clinic PC

  dba Advanced Counseling Services PC

  • Psychologist
  • Taylor, MI
  • NPI 1104930130

  Clinical

  NPD

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

{
    "created_epoch": "1633392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733184000000",
    "number": "1275205429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "53435 GRAND RIVER AVE STE 2500",
            "city": "NEW HUDSON",
            "state": "MI",
            "postal_code": "481658521",
            "telephone_number": "734-737-1200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "53435 GRAND RIVER AVE",
            "city": "NEW HUDSON",
            "state": "MI",
            "postal_code": "481658521",
            "telephone_number": "517-882-3732"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAMORO",
        "first_name": "DONOVAN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-10-05",
        "last_updated": "2024-12-03",
        "certification_date": "2024-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801117401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Steven R Hill, O.D.
• Emma Horvath, PTA
• Rajeev Jolly
• Kalai Kari Family Dentistry PLLC (Kalai Kari family dentistry)
• Kare Consulting LLC
• Mia Kochanek, PA-C
• Brittany Kozlowicz, LPC
• Huri Aaron Kushner, LMSW
• Amanda Marie Leach, MSN, RN, CPNP
• Janice Lee, LPC

• Clinical Social Worker in New Hudson, MI
• Providers in New Hudson, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.