Active NPI
Jeremy Drake, M.A, L.L.P.C
- Professional Counselor
- Grand Haven, MI
National Provider Identifier
1942432901
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 6401011440
- Practice address
- 14932 Mercury Dr
Grand Haven, MI 49417-9521 - Phone
- (616) 405-1702
- NPI assigned
- Aug 10, 2009
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 6401011440 | MI | Primary |
Addresses
Primary practice location
14932 Mercury Dr
Grand Haven, MI 49417-9521
Mailing address
14932 Mercury Dr
Grand Haven, MI 49417-9521
Phone (616) 405-1702
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)
- Not enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6401011440 | MI | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1249862400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1334188800000",
"number": "1942432901",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14932 MERCURY DR",
"city": "GRAND HAVEN",
"state": "MI",
"postal_code": "494179521",
"telephone_number": "616-405-1702"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14932 MERCURY DR",
"city": "GRAND HAVEN",
"state": "MI",
"postal_code": "494179521",
"telephone_number": "616-405-1702"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DRAKE",
"first_name": "JEREMY",
"credential": "M.A, L.L.P.C",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-08-10",
"last_updated": "2012-04-12",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MI",
"license": "6401011440",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Grand Haven, MI
- Sidney Arden Disbrow, D.C.
- Mary Elizabeth Dody Warnock, LMSW
- Barbara Anita Doorlag, LLP
- Douglas T. Johnson & Associates, Inc.
- Terrance L. Draeger, O.D.
- Nancy McKeon Dubuc, PHYSICAL THERAPIST
- Hunter Bradley Dulaney, D.C.
- Courtney Lyn Dumouchelle, MS, CCC-SLP
- Frank Young Duncan III, MD
- Dunegrass Counseling
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.