MEDICARE: MOTIVATE LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency
2	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1891654018
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MOTIVATE LLC

Provider Business Mailing Address
First Line	:	20472 COLUMBIA DR
Second Line	:
City	:	MACOMB
State	:	MI
Zip	:	48044-5755
Country	:	US
Telephone Number	:	708-271-3518
Fax Number	:	708-271-3518

Provider Business Practice Location Address
First Line	:	1302 LAPEER AVE
Second Line	:
City	:	PORT HURON
State	:	MI
Zip	:	48060-4354
Country	:	US
Telephone Number	:	708-271-3518
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	SHALITA MARIE MORRIS
Credential	:
Telephone Number	:	708-271-3518

Provider Enumeration Date	:	01/22/2026
Last Update Date	:	01/22/2026

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Directions to “MOTIVATE LLC ” Practice Location

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