MR. JACKIE MOORE MA
NPI 1629355870
Counselor - Addiction (Substance Use Disorder) in Grosse Pointe, MI

Q: What is Jackie Moore's NPI number?

The NPI number for Jackie Moore is 1629355870. It was assigned to this individual provider in the NPPES registry on November 15, 2011.

Q: What is Jackie Moore's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Addiction (Substance Use Disorder), with taxonomy code 101YA0400X.

Q: When was this NPI record last updated?

The NPPES record for Jackie Moore was last updated on November 15, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since November 15, 2011

18530 MACK AVE STE 101, GROSSE POINTE, MI 48236(313) 673-9073(313) 884-8442 Get Directions Write a Review

NPPES record last updated: November 15, 2011. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Mr. Jackie Moore Ma NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. JACKIE MOORE MA (NPI 1629355870) is an individual addiction (substance use disorder) provider in Grosse Pointe, Michigan, licensed in Michigan (6401007537) and active in the NPI registry since November 2011.

NPPES Registry Identity

NPI1629355870

Entity TypeIndividualMale

Primary Taxonomy101YA0400X

Provider Legal NameMR. JACKIE MOORECredential: MA

Location Address18530 MACK AVE STE 101Grosse Pointe, MI 48236-3254

Mailing Address18530 Mack Ave Ste 101Grosse Pointe, MI 48236-3254 · (313) 673-9073 · Fax (313) 884-8442

Phone(313) 673-9073

Fax(313) 884-8442

Sole ProprietorYes

Enumeration DateNovember 15, 2011

✔ NPI 1629355870 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyCounselor · Addiction (Substance Use Disorder)Behavioral Health & Social Service Providers

Taxonomy Code101YA0400X

License✔ Licensed in MI · 6401007537

Also ListedPsychologist · CounselingTaxonomy 103TC1900X · License 6301005272 (MI)

18530 MACK AVE STE 101, Grosse Pointe, MI 48236

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Priority Health.Insurance ›

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jackie Moore's NPI number?

The NPI number for Jackie Moore is 1629355870. It was assigned to this individual provider in the NPPES registry on November 15, 2011.

Where is Jackie Moore located?

Jackie Moore practices at 18530 Mack Ave Ste 101, Grosse Pointe, MI 48236. The listed phone number is (313) 673-9073.

What is Jackie Moore's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Addiction (Substance Use Disorder), with taxonomy code 101YA0400X.

What insurance does Jackie Moore accept?

Health plans from Priority Health list Jackie Moore as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Jackie Moore was last updated on November 15, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.