MR. WILLIE JEFFERSON (NPI# 1932212453) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932212453 |
| Entity Type | Individual |
| Full Name | MR. WILLIE JEFFERSON |
| Practice Address |
230 Huron Ave Port Huron MI 48060-3822 |
| Practice Telephone | 8109664473 |
| Practice Fax Number | 8109859498 |
| Mailing Telephone | 8109664473 |
| Mailing Fax Number | 8109859498 |
| Enumeration Date | 2006-08-17 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 373H00000X | Day Training/Habilitation Specialist | Nursing Service Related Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275848996 | Willie L Jefferson | Non-emergency Medical Transport (VAN) | 19351 Jefferson Rd, White Springs, FL 32096 | 2010-08-18 |
| 1689297046 | Willie Jefferson | Counselor | 3776 Youree Dr, Shreveport, LA 71105-2132 | 2020-05-20 |
| Street Address |
230 HURON AVE |
| City | PORT HURON |
| State | MI |
| Zip Code | 48060-3822 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164463626 | Anne D Switchulis | Social Worker | 230 Huron Ave, Port Huron, MI 48060-3822 | 2006-06-08 |
| 1447419650 | Michael A Nett | Day Training/Habilitation Specialist | 230 Huron Ave, Port Huron, MI 48060-3822 | 2008-06-03 |
| 1750597837 | Michael Jonathon Higgins II | Day Training/Habilitation Specialist | 230 Huron Ave, Port Huron, MI 48060-3822 | 2007-05-15 |
| 1063627792 | Dean Charles Hency | Day Training/Habilitation Specialist | 230 Huron Ave, Port Huron, MI 48060-3822 | 2007-05-14 |
| 1376768929 | Mark Stephen Meier | Day Training/Habilitation Specialist | 230 Huron Ave, Port Huron, MI 48060-3822 | 2007-04-16 |
| 1760567978 | Sean Horan | Day Training/Habilitation Specialist | 230 Huron Ave, Port Huron, MI 48060-3822 | 2006-10-26 |
| 1609963909 | Marty Lee Cook II | Day Training/Habilitation Specialist | 230 Huron Ave, Port Huron, MI 48060-3822 | 2006-10-06 |
| 1841309036 | Debra Jean Barnes | Day Training/Habilitation Specialist | 230 Huron Ave, Port Huron, MI 48060-3822 | 2006-08-30 |
| 1750490900 | Michael Clifford Brown | Social Worker | 230 Huron Ave, Port Huron, MI 48060-3822 | 2006-08-30 |
| 1376652941 | Thermond Kirkland | Counselor | 230 Huron Ave, Port Huron, MI 48060-3822 | 2006-08-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740897297 | Casey Edward Bicker | Behavior Technician | 3245 Keewahdin Rd; Fort Gratiot, Mi 48059, Port Huron, MI 48060 | 2020-09-29 |
| 1962032078 | Brianne Salchert | Peer Specialist | 1170 Michigan Rd., Port Huron, MI 48060 | 2020-01-17 |
| 1982123006 | Kenneth Shine Heuvelman | Counselor | 3522 Holland Park Ln, Port Huron, MI 48060 | 2017-09-11 |
| 1346767506 | Kelly Baker | Social Worker | 520 Superior St., Port Huron, MI 48060 | 2017-08-28 |
| 1326418609 | Jean Burleigh | Chore Provider | 614 Staton, Port Huron, MI 48060 | 2015-09-30 |
| 1205242161 | Lisa Gray | Counselor | 2885 W Rick Dr, Port Huron, MI 48060 | 2014-07-10 |
| 1861758880 | Aaron Overly | Surgery | 2609 Electric Ave Ste B&, Port Huron, MI 48060 | 2012-04-03 |
| 1942591508 | S Akram Ali | Surgery | 3270 Waldheim Dr, Port Huron, MI 48060 | 2011-04-29 |
| 1417258179 | Nicholas Alexander Tobianski | Physician Assistant | 3550 Pine Grove Avenue, Port Huron, MI 48060 | 2010-11-11 |
| 1598092769 | Blue Water Pharmacy LLC | Pharmacy | 1524 10th Street, Port Huron, MI 48060 | 2009-11-10 |
| Find all providers in zip 48060 | ||||
| Taxonomy Code | 373H00000X |
| Grouping | Nursing Service Related Providers |
| Classification | Day Training/Habilitation Specialist |
| Individuals experienced or trained in working with developmentally disabled individuals who need assistance in acquiring and maintaining life skills that enable them to cope more effectively with the demands of independent living. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952587487 | Autumn Lynn Westbrook | Day Training/Habilitation Specialist | 4166 Ravenswood Rd, Port Huron, MI 48060-7817 | 2008-01-15 |
| 1952587784 | Melana Marie Bennett | Day Training/Habilitation Specialist | 1214 Rawlins St, Port Huron, MI 48060-3658 | 2008-01-10 |
| 1114103959 | Kimberly Lynn Gremmer | Day Training/Habilitation Specialist | 822 Pine St Apt 3, Port Huron, MI 48060-5385 | 2008-01-10 |
| 1477666964 | Sammie M Matthews | Day Training/Habilitation Specialist | 1721 10 Ave, Port Huron, MI 48060-3822 | 2006-08-17 |
| 1780228205 | Matthew R Cuellar | Day Training/Habilitation Specialist | 3111 Electric Ave, Port Huron, MI 48060-8127 | 2019-10-29 |
| 1427619477 | Samantha L Brewer | Day Training/Habilitation Specialist | 3111 Electric Ave, Port Huron, MI 48060-8127 | 2019-06-20 |
| 1215357926 | Linda Herron | Day Training/Habilitation Specialist | 3111 Electric Ave, Port Huron, MI 48060-8127 | 2014-04-21 |
| 1184043309 | Devon Brown | Day Training/Habilitation Specialist | 3111 Electric Ave, Port Huron, MI 48060-8127 | 2014-04-15 |
| 1447419650 | Michael A Nett | Day Training/Habilitation Specialist | 230 Huron Ave, Port Huron, MI 48060-3822 | 2008-06-03 |
| 1750597837 | Michael Jonathon Higgins II | Day Training/Habilitation Specialist | 230 Huron Ave, Port Huron, MI 48060-3822 | 2007-05-15 |
| Find all providers in PORT HURON | ||||
| City | PORT HURON |
| Zip Code | 48060 |
Please comment or provide details below to improve the information on MR. WILLIE JEFFERSON.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.