Active NPI
Jacque D Moss, FLP
- Psychologist
- East Lansing, MI
National Provider Identifier
1851357438
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 6301005067
- Practice address
- 2310 Raby Rd
East Lansing, MI 48823-7761 - Phone
- (235) 176-7697
- NPI assigned
- Apr 24, 2006
- Last updated
- Jan 29, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 6301005067 | MI | Primary |
Addresses
Primary practice location
2310 Raby Rd
East Lansing, MI 48823-7761
Mailing address
PO Box 10
Mason, MI 48854-0010
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1145836800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1580256000000",
"number": "1851357438",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 10",
"city": "MASON",
"state": "MI",
"postal_code": "488540010"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2310 RABY RD",
"city": "EAST LANSING",
"state": "MI",
"postal_code": "488237761",
"telephone_number": "235-176-7697"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOSS",
"first_name": "JACQUE",
"middle_name": "D",
"credential": "FLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-04-24",
"last_updated": "2020-01-29",
"certification_date": "2020-01-29",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MI",
"license": "6301005067",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in East Lansing, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.