Connor Keoni Jewell, MA, LLPC

Primary specialty

CounselorTaxonomy code 101Y00000X

Practice address

14800 E Old US Highway 12
Chelsea, MI 48118-2110

Phone

(734) 719-0380

Fax

(734) 292-8239

NPI assigned

Sep 10, 2019

Last updated

Jul 3, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Timber Creek Counseling LLCGroup PAC ID 4688004815, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Timber Creek Counseling, LLC

  • Clinical Psychologist
  • Chelsea, MI
  • NPI 1194213322
  Medicare reassignment Care Compare group NPD
• Timber Creek Foundation

  • Clinical Psychologist
  • Chelsea, MI
  • NPI 1689437386
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1568073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719964800000",
    "number": "1205485497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14800 E OLD US HIGHWAY 12",
            "city": "CHELSEA",
            "state": "MI",
            "postal_code": "481182110",
            "telephone_number": "734-719-0380",
            "fax_number": "734-292-8239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14800 E OLD US HIGHWAY 12",
            "city": "CHELSEA",
            "state": "MI",
            "postal_code": "481182110",
            "telephone_number": "734-719-0380",
            "fax_number": "734-292-8239"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2301 S Huron Pkwy Ste 3D",
            "address_purpose": "LOCATION",
            "city": "Ann Arbor",
            "state": "MI",
            "postal_code": "481045133",
            "country_code": "US",
            "telephone_number": "734-719-0380",
            "fax_number": "734-292-8239",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JEWELL",
        "first_name": "CONNOR",
        "middle_name": "KEONI",
        "credential": "MA, LLPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-09-10",
        "last_updated": "2024-07-03",
        "certification_date": "2024-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gillian Jackson, LLMSW
• Jaimie Jackson, M.A. CCC-SLP
• Lawrence Jajou, DO
• Miranda Kathryn James, OT
• Naela Berry Jenkins, CPNP
• Andrew James Johnson, O.D.
• Mark Thomas Johnson, PHARMD
• Timothy Edward Johnson
• Virginia Johnson, M.D.
• Jona K Gill MD PC (Chelsea Dermatology)

• Counselor in Chelsea, MI
• Providers in Chelsea, MI by specialty
• Counselor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.