Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MR. JACKIE MOORE, MA
Active Sole ProprietorMR. JACKIE MOORE, MA is a Addiction (Substance Use Disorder) Counselor healthcare provider located in GROSSE POINTE, Michigan. NPI 1629355870 is currently active in the NPPES registry. Verify at CMS.
Addiction (Substance Use Disorder) Counselor · GROSSE POINTE, MI
Registration Details
- NPI Number
- 1629355870
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Nov 15, 2011 (14.790104198343 yrs)
- Last Updated
- Nov 15, 2011
- Licenses
-
6401007537 (MI)6301005272 (MI)
- Sole Proprietor
- Yes
Practice Information
- Address
-
18530 MACK AVE STE 101GROSSE POINTE, MI, 482363254Browse MI providers · Browse ZIP 48236
- Phone
- 3136739073
- Fax
- 3138848442
- Primary Specialty
-
Addiction (Substance Use Disorder) Counselor
101YA0400X
- Additional Specialty
- Counseling Psychologist
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.