Healthcare Provider Details

I. General information

NPI: 1740738871
Provider Name (Legal Business Name): JEFFREY MARK CATES II LLMSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/19/2016
Last Update Date: 01/07/2026
Certification Date: 01/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14675 DOWNEY RD
CAPAC MI
48014-3121
US

IV. Provider business mailing address

3111 ELECTRIC AVE
PORT HURON MI
48060-8127
US

V. Phone/Fax

Practice location:
  • Phone: 810-395-4343
  • Fax:
Mailing address:
  • Phone: 810-985-8900
  • Fax: 810-966-3393

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6851120620
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: