Provider Demographics
NPI:1215147269
Name:MOTRINC, KATRINA MARY (LMSW)
Entity type:Individual
Prefix:MRS
First Name:KATRINA
Middle Name:MARY
Last Name:MOTRINC
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4900 WEST RD
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:MI
Mailing Address - Zip Code:48094-2656
Mailing Address - Country:US
Mailing Address - Phone:248-252-9100
Mailing Address - Fax:
Practice Address - Street 1:6303 26 MILE RD STE 120
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:MI
Practice Address - Zip Code:48094-3851
Practice Address - Country:US
Practice Address - Phone:586-232-5089
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-22
Last Update Date:2019-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010862101041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical