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Individual

JACOB MOON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MS, LMFT, LPC

Contact information

Practice address
146 MONROE CENTER ST NW STE 1104, GRAND RAPIDS, MI 49503-2820
(616) 626-1082
Mailing address
1809 COLLEGE AVE SE, GRAND RAPIDS, MI 49507-2621
(616) 209-8854

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
6401224962
MI
106H00000X
Marriage & Family Therapist
Primary
4101007162
MI

Other

Enumeration date
02/19/2019
Last updated
09/30/2025
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