Michigan Institute for Prevention and Intervention

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

MICHIGAN INSTITUTE FOR PREVENTION AND INTERVENTION

Practice address

9851 Hamilton Ave
Detroit, MI 48202-1424

Phone

(313) 883-7377

Fax

(313) 883-3957

NPI assigned

Nov 12, 2008

Last updated

Nov 12, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Jackie Moore, MA, LLP, LPCNPI 1629355870

Title

Owner

Phone

(313) 883-7377

Specialties & licenses 2

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jackie Moore, MA

  • Addiction (Substance Use Disorder) Counselor
  • Grosse Pointe, MI
  • NPI 1629355870
  NPD (past) Authorized official

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

{
    "created_epoch": "1226448000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1226448000000",
    "number": "1942454392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18530 MACK AVE STE 101",
            "city": "GROSSE POINTE FARMS",
            "state": "MI",
            "postal_code": "482363254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9851 HAMILTON AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482021424",
            "telephone_number": "313-883-7377",
            "fax_number": "313-883-3957"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHIGAN INSTITUTE FOR PREVENTION AND INTERVENTION",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-12",
        "last_updated": "2008-11-12",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "JACKIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "313-883-7377",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MA, LLP, LPC"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michigan Foot Surgeons, P.C.
• Michigan Frontline Laboratory LLC
• Michigan Health Center PC
• Michigan Home Help Services LLC
• Michigan Infection Specialists PLLC
• Michigan Magical
• Michigan Medical Mall
• Michigan Medical Specialists PC
• Michigan Pain&Spine Clinic PLLC
• Michigan Pediatric Cardiovascular Surgeons PC

• Clinical Social Worker in Detroit, MI
• Providers in Detroit, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.