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.

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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