Mnodern Ecclesia

Primary specialty

CounselorTaxonomy code 101Y00000X

Legal business name

MNODERN ECCLESIA

Practice address

597 San Pablo Dr
Stone Mountain, GA 30083-3855

Phone

(573) 479-0490

NPI assigned

Dec 12, 2024

Last updated

Dec 12, 2024By 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. Willie J SingletonNPI 1699570366

Title

Director

Phone

(573) 447-9049

Specialties & licenses 1

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.

• Willie J Singleton Jr.

  • Case Manager/Care Coordinator
  • Kennett, MO
  • NPI 1699570366
  NPD Authorized official

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

{
    "created_epoch": "1733961600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733961600000",
    "number": "1952118051",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 262",
            "city": "CARUTHERSVILLE",
            "state": "MO",
            "postal_code": "638300262",
            "telephone_number": "573-497-0490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "597 SAN PABLO DR",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300833855",
            "telephone_number": "573-479-0490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MNODERN ECCLESIA",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-12-12",
        "last_updated": "2024-12-12",
        "certification_date": "2024-12-12",
        "status": "A",
        "authorized_official_last_name": "SINGLETON",
        "authorized_official_first_name": "WILLIE",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "573-447-9049",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Merica Mitchell, CD, CBE
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• Michael Moccio, D.C.
• Hassan Ali Moeti, DMD
• Selamawit Mola, FNP
• Lorna Angela Mollison, RN.
• Alisa Monfalcone, LCSW

• Counselor in Stone Mountain, GA
• Providers in Stone Mountain, GA by specialty
• Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2024; 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.