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

Mr. Jackie Moore, MA

Individual provider Addiction (Substance Use Disorder) Counselor · NPI 1629355870

Mr. Jackie Moore, MA is an Addiction (Substance Use Disorder) Counselor in Grosse Pointe, Michigan. Practices as a sole proprietor. Licensed in Michigan.

Licensed in
MI
In the registry since
2011
Specialties on file
2
What do these letters mean?
MA — Master of Arts
A graduate arts degree.

See every abbreviation used in this directory →

Practice location Address checks out

18530 Mack Ave Ste 101
Grosse Pointe, MI 48236-3254
Phone: (313) 673-9073
Fax: (313) 884-8442
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Addiction (Substance Use Disorder) Counselor (primary) Taxonomy 101YA0400X · Licence 6401007537 (MI)
Counseling Psychologist Taxonomy 103TC1900X · Licence 6301005272 (MI)

Record details

NPI number1629355870
Entity typeIndividual (Type 1)
GenderMale
Credentials MA
Sole proprietorYes
NPI enumeratedNovember 15, 2011
Last updated in NPPESNovember 15, 2011
Mailing address18530 Mack Ave Ste 101, Grosse Pointe, MI 48236-3254