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KATHERINE JACK LPC
NPI 1588216048
Counselor - Professional in Grand Rapids, MI

Active since July 15, 2019PECOS Enrolled
3351 CLAYSTONE ST SE STE G32, GRAND RAPIDS, MI 49546(616) 259-6827 Get Directions Write a Review

NPPES record last updated: April 19, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Apr 19, 2024, Jul 15, 2019 (2 updates tracked since 2019).

About Katherine Jack Lpc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KATHERINE JACK LPC (NPI 1588216048) is an individual professional provider in Grand Rapids, Michigan, licensed in Michigan (6401222851) and active in the NPI registry since July 2019. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1588216048
Entity TypeIndividualFemale
Primary Taxonomy101YP2500X
Provider Legal NameKATHERINE JACKCredential: LPC
Location Address3351 CLAYSTONE ST SE STE G32Grand Rapids, MI 49546-5794
Mailing Address2042 Innwood Dr SeKentwood, MI 49508-5066 · (616) 260-4597
Phone(616) 259-6827
Sole ProprietorNo
Enumeration DateJuly 15, 2019
Last NPPES UpdateApril 19, 20242 updates tracked since enumeration
NPPES CertifiedApril 19, 2024
✔ NPI 1588216048 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers
Taxonomy Code101YP2500X
Licenses✔ Licensed in MI · 6401222851✔ Licensed in CO · 0019661
3351 CLAYSTONE ST SE STE G32, Grand Rapids, MI 49546
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company, McLaren Health Plan Community and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Katherine Jack Lpc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer– Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KYRA ROBERTS LCMHCA
Counselor (Mental Health)
3351 CLAYSTONE ST SE STE G32
GRAND RAPIDS, MI 49546
Kent County (352) 238-1608
SHAINA JOHNSON LMSW
Social Worker (Clinical)
3351 CLAYSTONE ST SE STE G32
GRAND RAPIDS, MI 49546
Kent County (616) 209-8684
SARAH PATTISON LLMSW
Social Worker (Clinical)
3351 CLAYSTONE ST SE STE G32
GRAND RAPIDS, MI 49546
Kent County (616) 425-2412
ANDRIA BREMER SAVARA LLPC, LLMFT
Counselor
3351 CLAYSTONE ST SE STE G32
GRAND RAPIDS, MI 49546
Kent County (616) 425-2412
FAITH L HERENDEEN
Social Worker (Clinical)
3351 CLAYSTONE ST SE STE G32
GRAND RAPIDS, MI 49546
Kent County (616) 202-2809
JUSTIN BENJAMIN MCCOY LLPC
Counselor (Mental Health)
3351 CLAYSTONE ST SE STE G32
GRAND RAPIDS, MI 49546
Kent County (616) 219-0499

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Katherine Jack's NPI number?

The NPI number for Katherine Jack is 1588216048. It was assigned to this individual provider in the NPPES registry on July 15, 2019.

Where is Katherine Jack located?

Katherine Jack practices at 3351 Claystone St SE Ste G32, Grand Rapids, MI 49546. The listed phone number is (616) 259-6827.

What is Katherine Jack's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

Is Katherine Jack enrolled in Medicare?

Yes. Katherine Jack is registered in the Medicare PECOS enrollment system.

What insurance does Katherine Jack accept?

Health plans from Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company, McLaren Health Plan Community, Oscar Insurance Company and Priority Health and 2 other insurers list Katherine Jack as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Katherine Jack was last updated on April 19, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.