Jonathan Perry Moore, LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

6451023316 Issued in MI

Practice address

170 College Ave Ste 310
Holland, MI 49423-2982

Phone

(616) 745-6748

NPI assigned

Oct 17, 2023

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Mental Health Counselor

Education

Other, 2023

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Second Story Counseling II LLC

  • Counselor
  • Hudsonville, MI
  • NPI 1013460716
  Medicare reassignment NPD

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

{
    "created_epoch": "1697500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697500800000",
    "number": "1982486643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "170 COLLEGE AVE STE 310",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494232982",
            "telephone_number": "616-745-6748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "170 COLLEGE AVE STE 310",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494232982",
            "telephone_number": "616-745-6748"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "JONATHAN",
        "middle_name": "PERRY",
        "credential": "LLC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-10-17",
        "last_updated": "2023-10-17",
        "certification_date": "2023-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MI",
            "license": "6451023316",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniel Scott Molenaar, P.T.
• Ann Monroe, M.D.
• Marla Jeanne Montbriand
• Karen Ardel Monterusso, PA
• Mary Kathryn Mooi, LCSW
• Meghan Moore, OTR
• Sherry Moore
• Jocelyn Morales
• Valente Oswaldo Morales, CHW
• Eryl S Morgan-Jenkins, PT, MHS

• Mental Health Counselor in Holland, MI
• Providers in Holland, MI by specialty
• Mental Health Counselor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.