Jacob Mouliert

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

PC017036 Issued in PA

Practice address

1817 Olde Homestead LN
Lancaster, PA 17601-6751

Phone

(223) 275-3158

NPI assigned

Sep 22, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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 and National Provider Directory roles.

• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  PA, Professional

  Medicare reassignment NPD

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

{
    "created_epoch": "1632268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744675200000",
    "number": "1417628280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 ROSELLE AVE",
            "city": "LANCASTER",
            "state": "PA",
            "postal_code": "176036698",
            "telephone_number": "609-432-3081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1817 OLDE HOMESTEAD LN",
            "city": "LANCASTER",
            "state": "PA",
            "postal_code": "176016751",
            "telephone_number": "223-275-3158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOULIERT",
        "first_name": "JACOB",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-09-22",
        "last_updated": "2025-04-15",
        "certification_date": "2025-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "PA",
            "license": "PC017036",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Georgia M Moshos, CRNP
• Hannah Mosser, MA
• Amy M Mosteller, OT
• Margaret A Motl, MD
• Carolyn A Mottor-Rivera, MA, LPC, CAADC
• Shakinah Moultrie, LPN
• Katie Hoch Mount, M.A., L.P.C.
• Mountain Laurel Midwifery
• Move Forward Counseling, LLC
• Allison Moyer

• Professional Counselor in Lancaster, PA
• Providers in Lancaster, PA by specialty
• Professional Counselor in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2025; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.