Individual provider Active NPI

Donald Rene Motte, LBSW QMHP QMRP

  • Social Worker
  • Port Huron, MI
National Provider Identifier
1811004450
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
6801059421 Issued in MI
Practice address
230 Huron Ave
Port Huron, MI 48060-3822
Phone
(810) 966-4464
Fax
(810) 985-9448
NPI assigned
Aug 23, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 6801059421 MI Primary

Addresses

Primary practice location

230 Huron Ave
Port Huron, MI 48060-3822

Mailing address

230 Huron Ave
Port Huron, MI 48060-3822
Phone (810) 966-4464

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
6801059421MIMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1156291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1811004450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 HURON AVE",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "480603822",
            "telephone_number": "810-966-4464",
            "fax_number": "810-985-9448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 HURON AVE",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "480603822",
            "telephone_number": "810-966-4464",
            "fax_number": "810-985-9448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOTTE",
        "first_name": "DONALD",
        "middle_name": "RENE",
        "name_prefix": "Mr.",
        "credential": "LBSW QMHP QMRP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6801059421",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Huron, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.