Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Jonathan Perry Moore, LLC

Individual provider Mental Health Counselor · NPI 1982486643

Jonathan Perry Moore, LLC is a Mental Health Counselor in Holland, Michigan. Qualified in 2023, 3 years ago. Licensed in Michigan.

Years since qualifying
3
Licensed in
MI
In the registry since
2023
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Practice location Address checks out

170 College Ave Ste 310
Holland, MI 49423-2982
Phone: (616) 745-6748
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Mental Health Counselor (primary) Taxonomy 101YM0800X · Licence 6451023316 (MI)

Record details

NPI number1982486643
Entity typeIndividual (Type 1)
GenderMale
Credentials LLC
Sole proprietorNo
NPI enumeratedOctober 17, 2023
Last updated in NPPESOctober 17, 2023
Certification dateOctober 17, 2023

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyMENTAL HEALTH COUNSELOR
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

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