JEREMY WALLACE JACK LCPC
NPI 1396039897
Counselor in Billings, MT
NPI Status: Active since June 02, 2011
Contact Information
1411 MAIN ST STE B-C
BILLINGS, MT
ZIP 59105
Phone: (406) 606-9552
- Individual
- Male
- Counselor
- Accepts Insurance
- PECOS Enrolled
About JEREMY JACK
This page provides the complete NPI Profile along with additional information for Jeremy Jack, a provider established in Billings, Montana with a medical specialization in Counselor. The healthcare provider is registered in the NPI registry with number 1396039897 assigned on June 2011. The practitioner's primary taxonomy code is 101Y00000X with license number 31177 (MT). The provider is registered as an individual and his NPI record was last updated 5 years ago.
- NPI
- 1396039897
- Provider Name
- JEREMY WALLACE JACK LCPC
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 1411 MAIN ST STE B-C BILLINGS, MT 59105
- Location Phone
- (406) 606-9552
- Mailing Address
- 1411 MAIN ST # B-C BILLINGS, MT 59105
- Mailing Phone
- (406) 606-9552
- Is Sole Proprietor?
- No
- Enumeration Date
- 06-02-2011
- Last Update Date
- 08-31-2020
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Counselor
- Taxonomy Code
- 101Y00000X
- Type
- Behavioral Health & Social Service Providers
- License No.
- 31177
- License State
- MT
- Taxonomy Description
- A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 171M00000X | Other Service Providers | Case Manager/Care Coordinator | |
| 2 | 172V00000X | Other Service Providers | Community Health Worker |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Blue Focus Bronze POS? 205 - POS
- Blue Focus Bronze POS? 705 - POS
- Blue Focus Bronze POS? Standard - POS
- Blue Focus Gold POS? 207 - POS
- Blue Focus Gold POS? 902 - POS
- Blue Focus Gold POS? Standard - POS
- Blue Focus Silver POS? 206 - POS
- Blue Focus Silver POS? 903 - POS
- Blue Focus Silver POS? Standard - POS
- Blue Preferred Bronze PPO? 201 - PPO
- Blue Preferred Bronze PPO? 202 - PPO
- Blue Preferred Bronze PPO? Standard - PPO
- Blue Preferred Gold PPO? 204 - PPO
- Blue Preferred Gold PPO? 901 - PPO
- Blue Preferred Gold PPO? Standard - PPO
- Blue Preferred Security PPO? 200 - PPO
- Blue Preferred Silver PPO? 203 - PPO
- Blue Preferred Silver PPO? 308 - PPO
- Blue Preferred Silver PPO? Standard - PPO
- Connect Bronze Expanded Standard - PPO
- Connect Bronze HDHP - PPO
- Connect Catastrophic - PPO
- Connect Gold - PPO
- Connect Gold Standard - PPO
- Connect Silver - PPO
- Connect Silver Standard - PPO
- High Plains Bronze HDHP - PPO
- High Plains Bronze Standard Expanded - PPO
- High Plains Gold - PPO
- High Plains Gold HDHP - PPO
- High Plains Gold Standard - PPO
- High Plains Silver - PPO
- High Plains Silver Standard - PPO
- Plus Bronze Expanded - PPO
- Plus Bronze Standard Expanded - PPO
- Plus Gold - PPO
- Plus Gold Standard - PPO
- Plus Silver Standard - PPO
- Rocky Mountain Bronze Standard Expanded - PPO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Medicare Participation & PECOS Enrollment Status
Jeremy Jack is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging and Durable Medical Equipment (DME).
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): No
Eligible to Order or Refer Power Mobility Devices: No
Reviews for JEREMY WALLACE JACK LCPC
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 3 | 9 | 6 | 0 | 3 | 9 | 8 | 9 | 7 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 3 | 18 | 6 | 0 | 3 | 18 | 8 | 18 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 3 + 1 + 8 + 6 + 0 + 3 + 1 + 8 + 8 + 1 + 8 + 24 = 73 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 80 - 73 = 7 | 7 | ||||||||
The NPI number 1396039897 is valid because the calculated check digit 7 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 5 providers are registered at the same or nearby location.
CHERISH L ROBERTS LCPC
Counselor
(Professional)
1411 MAIN ST STE B-C
BILLINGS, MT
ZIP 59105
HALEY A BRENSDAL LPC
Counselor
(Professional)
1411 MAIN ST STE B-C
BILLINGS, MT
ZIP 59105
AMIE LAURAYNE HAVNER MS, LCPC
Counselor
(Professional)
1411 MAIN ST STE B-C
BILLINGS, MT
ZIP 59105
CROSSWAY INCORPORATED
Counselor
(Mental Health)
1411 MAIN ST STE B-C
BILLINGS, MT
ZIP 59105
LATITIA HARRY LCPC
Counselor
(Professional)
1411 MAIN ST STE B-C
BILLINGS, MT
ZIP 59105
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1396039897, enumerated as an "individual" on June 02, 2011.
The provider is located at 1411 MAIN ST STE B-C BILLINGS, MT 59105 and the phone number is (406) 606-9552.
Counselor with taxonomy code 101Y00000X.
The provider might be accepting Accepts: Blue Cross and Blue Shield of Montana and Mountain. Please consult your insurance carrier or call the provider to verify.
