Provider Demographics
NPI:1144611765
Name:JAMES, JAMOR (ACTT THERAPIST)
Entity type:Individual
Prefix:MR
First Name:JAMOR
Middle Name:
Last Name:JAMES
Suffix:
Gender:M
Credentials:ACTT THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 130
Mailing Address - Street 2:
Mailing Address - City:ALLEGAN
Mailing Address - State:MI
Mailing Address - Zip Code:49010-0130
Mailing Address - Country:US
Mailing Address - Phone:269-673-3384
Mailing Address - Fax:269-686-5201
Practice Address - Street 1:3283 122ND AVE
Practice Address - Street 2:
Practice Address - City:ALLEGAN
Practice Address - State:MI
Practice Address - Zip Code:49010-9590
Practice Address - Country:US
Practice Address - Phone:269-673-3384
Practice Address - Fax:269-686-5201
Is Sole Proprietor?:No
Enumeration Date:2015-02-18
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI171M00000X
175T00000X
MI68511173751041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
No175T00000XOther Service ProvidersPeer Specialist