MR. CHRISTOPHER SCOTT MOON
NPI 1689124117
Counselor - Professional in Grand Rapids, MI

Q: What is Christopher Moon's NPI number?

The NPI number for Christopher Moon is 1689124117. It was assigned to this individual provider in the NPPES registry on October 7, 2016.

Q: What is Christopher Moon's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

Q: When was this NPI record last updated?

The NPPES record for Christopher Moon was last updated on June 6, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since October 07, 2016PECOS Enrolled

790 FULLER AVE NE, GRAND RAPIDS, MI 49503(616) 336-3909(616) 336-8830 Get Directions Write a Review

NPPES record last updated: June 6, 2024. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jun 6, 2024, Mar 7, 2024, Aug 24, 2021 (3 updates tracked since 2021).

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About Mr. Christopher Scott Moon NPPES

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

MR. CHRISTOPHER SCOTT MOON (NPI 1689124117) is an individual professional provider in Grand Rapids, Michigan, licensed in Michigan (6401223787) and active in the NPI registry since October 2016. He is enrolled in Medicare PECOS and maintains a secondary practice location in Grand Rapids.

NPPES Registry Identity

NPI1689124117

Entity TypeIndividualMale

Primary Taxonomy101YP2500X

Provider Legal NameMR. CHRISTOPHER SCOTT MOON

Location Address790 FULLER AVE NEGrand Rapids, MI 49503

Mailing Address790 Fuller Ave NeGrand Rapids, MI 49503-1918 · (616) 336-3909 · Fax (616) 336-8830

Phone(616) 336-3909

Fax(616) 336-8830

Sole ProprietorNo

Enumeration DateOctober 7, 2016

Last NPPES UpdateJune 6, 20243 updates tracked since enumeration

NPPES CertifiedJune 6, 2024

✔ NPI 1689124117 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers

Taxonomy Code101YP2500X

License✔ Licensed in MI · 6401223787

Also ListedCounselor · Addiction (Substance Use Disorder)Taxonomy 101YA0400X

Also ListedCounselor · Mental HealthTaxonomy 101YM0800X

790 FULLER AVE NE, Grand Rapids, MI 49503

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Secondary Practice Location 1

Location 13300 36th St SEGrand Rapids, MI 49512-2810 · Phone (616) 942-2110

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company, Oscar Insurance Company and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mr. Christopher Scott Moon is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ERIN MAY MA LLP LPC CAADC

Psychologist (Counseling)