Michigan-Online Therapy PLLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

MICHIGAN-ONLINE THERAPY PLLC

Practice address

3970 Philrose Dr
Jackson, MI 49201-9129

Phone

(765) 543-7227

NPI assigned

Nov 11, 2019

Organization subpart

No

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

Authorized official

Name

Jessica Van Cleave, LPCNPI 1316364862

Title

Owner

Phone

(517) 798-1527

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jessica Van Cleave, MA, LPC

  • Counselor
  • Jackson, MI
  • NPI 1316364862
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1573430400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710979200000",
    "number": "1316582646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3970 PHILROSE DR",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492019129",
            "telephone_number": "765-543-7227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3970 PHILROSE DR",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492019129",
            "telephone_number": "765-543-7227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHIGAN-ONLINE THERAPY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-11-11",
        "last_updated": "2024-03-21",
        "certification_date": "2024-03-21",
        "status": "A",
        "authorized_official_last_name": "VAN CLEAVE",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "517-798-1527",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1316582646",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI2",
            "identifier": "1316582646",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michigan Family Chiropractic-Jackson
• Michigan Family Practice, LLC
• Michigan Institute of Neurological Diseases, PLLC
• Michigan Sleep Diagnostic Center, LLC
• Michigan Visiting Care
• Mid Michigan Eye Care Center, PC
• Mid-Michigan Gastroenterology Consultants PC
• Jamie Middlebrook
• Amber Midena
• Diana L. Midgley, L.M.S.W.

• Mental Health Counselor in Jackson, MI
• Providers in Jackson, MI by specialty
• Mental Health Counselor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.