Individual provider Active NPI

Jonah Conner

  • Mental Health Counselor
  • Flint, MI
National Provider Identifier
1508639188
Registry record updated Nov 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
6451023088 Issued in MI
Practice address
5406 Gateway Ctr Ste E
Flint, MI 48507-3933
Phone
(989) 220-3060
NPI assigned
Nov 6, 2023
Last updated
Nov 6, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 6451023088 MI Primary

Addresses

Primary practice location

5406 Gateway Ctr Ste E
Flint, MI 48507-3933

Mailing address

5406 Gateway Ctr Ste E
Flint, MI 48507-3933

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20260623002275 MI Practitioner - Mental Health Counselor 2264905108 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Oakland Univ, William Beaumont School of Medicine, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Maple Leaf Counseling Services LLCGroup PAC ID 0648642017, 9 clinicians

Practice addresses (Care Compare)

33 White Tail Creek Rd
Suite 2
Saginaw, MI 48638-5896
Phone (989) 220-3060

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6451023088MIMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Maple Leaf Counseling Services LLC Mental Health CurrentSince Jan 1, 2024 Accepting new patients

Locations

5406 Gateway Ctr
Ste E
Grand Blanc, MI 48507
Phone (586) 219-1924

33 White Tail Creek Rd
Ste 2
Saginaw, MI 48638
Phone (989) 220-3060

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1699228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699228800000",
    "number": "1508639188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5406 GATEWAY CTR STE E",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485073933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5406 GATEWAY CTR STE E",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485073933",
            "telephone_number": "989-220-3060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONNER",
        "first_name": "JONAH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-11-06",
        "last_updated": "2023-11-06",
        "certification_date": "2023-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MI",
            "license": "6451023088",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flint, MI

Sources for this page

Verify at the official NPI Registry.