Individual provider Active NPI

Carol Ann Mann, LBSW QMRP

  • Social Worker
  • Port Huron, MI
National Provider Identifier
1811005267
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
6802073017 Issued in MI
Practice address
230 Huron Ave
Port Huron, MI 48060-3822
Phone
(810) 966-4468
Fax
(810) 985-9448
NPI assigned
Aug 27, 2006
Sex
Female
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 6802073017 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) 966-4468

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
6802073017MIMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1156636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1811005267",
    "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": "810-966-4468",
            "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": "810-966-4468",
            "fax_number": "810-985-9448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANN",
        "first_name": "CAROL",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "LBSW QMRP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6802073017",
            "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.