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HEATHER JACK
NPI 1588926950
Counselor in Buffalo, NY

Active since June 12, 2012PECOS Enrolled
3020 BAILEY AVE, 2ND FLOOR, BUFFALO, NY 14215(716) 831-1800(716) 831-1818 Get Directions Write a Review

NPPES record last updated: June 12, 2012. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Heather Jack NPPES

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

HEATHER JACK (NPI 1588926950) is an individual counselor in Buffalo, New York and active in the NPI registry since June 2012. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1588926950
Entity TypeIndividualFemale
Primary Taxonomy101Y00000X
Provider Legal NameHEATHER JACK
Location Address3020 BAILEY AVE, 2ND FLOORBuffalo, NY 14215-2814
Mailing Address3020 Bailey Ave, 2nd FloorBuffalo, NY 14215-2814 · (716) 831-1800 · Fax (716) 831-1818
Phone(716) 831-1800
Fax(716) 831-1818
Sole ProprietorNo
Enumeration DateJune 12, 2012
✔ NPI 1588926950 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselorBehavioral Health & Social Service Providers
Taxonomy Code101Y00000X
Definition

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.

3020 BAILEY AVE, Buffalo, NY 14215
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Heather Jack 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 20

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

REBEKAH MOSHER
Counselor (Addiction (Substance Use Disorder))
3020 BAILEY AVE, 2ND FLOOR
BUFFALO, NY 14215
Erie County (716) 831-1800
BONNIE PARKOT
Counselor
3020 BAILEY AVE
BUFFALO, NY 14215
Erie County (716) 831-2700
BLAIR BUCZKOWSKI
Registered Nurse
3020 BAILEY AVE
BUFFALO, NY 14215
Erie County (716) 831-2700
VANESSA CHINEMELUM ABUDEI
Counselor
3020 BAILEY AVE
BUFFALO, NY 14215
Erie County (716) 833-3622
MRS. SARAH KATHRYN HALL MS
Counselor (Addiction (Substance Use Disorder))
3020 BAILEY AVE
BUFFALO, NY 14215
Erie County (716) 831-1850
MS. KELLY ANN SPEARS CASAC-T
Counselor (Mental Health)
3020 BAILEY AVE
BUFFALO, NY 14215
Erie County (716) 830-1800
RONALD G KRASKA O.T.R.
Counselor (Mental Health)
3020 BAILEY AVE
BUFFALO, NY 14215
Erie County (716) 831-1800
HEATHER MENDYK
Counselor (Addiction (Substance Use Disorder))
3020 BAILEY AVE, 2ND FLOOR
BUFFALO, NY 14215
Erie County (716) 831-1800

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 Heather Jack's NPI number?

The NPI number for Heather Jack is 1588926950. It was assigned to this individual provider in the NPPES registry on June 12, 2012.

Where is Heather Jack located?

Heather Jack practices at 3020 Bailey Ave 2nd Floor, Buffalo, NY 14215. The listed phone number is (716) 831-1800.

What is Heather Jack's specialty?

The primary specialty registered for this NPI is Counselor with taxonomy code 101Y00000X.

Is Heather Jack enrolled in Medicare?

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

When was this NPI record last updated?

The NPPES record for Heather Jack was last updated on June 12, 2012. NPI Profile syncs with the weekly NPPES data releases published by CMS.