CARLA JACK LMHC
NPI 1780050807
Counselor - Mental Health in Forest Hills, NY

Active since August 12, 2015PECOS Enrolled
10326 68TH RD, FOREST HILLS, NY 11375(718) 261-3330 Get Directions Write a Review

NPPES record last updated: January 31, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Oct 3, 2022, Dec 2, 2019, Nov 25, 2019 (3 updates tracked since 2019).

About Carla Jack Lmhc NPPES

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

CARLA JACK LMHC (NPI 1780050807) is an individual mental health provider in Forest Hills, New York, licensed in New York (010630) and active in the NPI registry since August 2015. She is enrolled in Medicare PECOS and maintains a secondary practice location in Brooklyn.

NPPES Registry Identity

NPI1780050807
Entity TypeIndividualFemale
Primary Taxonomy101YM0800X
Provider Legal NameCARLA JACKCredential: LMHC
Location Address10326 68TH RDForest Hills, NY 11375-3200
Mailing Address14021 Coombs StSpringfield Gardens, NY 11413-2675 · (929) 385-6765
Sole ProprietorNo
Enumeration DateAugust 12, 2015
Last NPPES UpdateJanuary 31, 20253 updates tracked since enumeration
NPPES CertifiedJanuary 31, 2025
NPI 1780050807 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
License Licensed in NY · 010630
10326 68TH RD, Forest Hills, NY 11375

Secondary Practice Location 1

Location 1209 Jamaica Ave # 11Brooklyn, NY 11207-2053 · Phone (718) 309-7935 · Fax (718) 455-0951

Other Identifiers 1

Other634459630NY · Nys Id

Accepted 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)

Carla Jack Lmhc 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.

Social Worker
10326 68TH RD
FOREST HILLS, NY 11375
Social Worker
10326 68TH RD, APARTMENT A41
FOREST HILLS, NY 11375
Psychologist (Group Psychotherapy)
10326 68TH RD
FOREST HILLS, NY 11375
Counselor (Mental Health)
10326 68TH RD
FOREST HILLS, NY 11375
Clinic/Center (Adult Mental Health)
10326 68TH RD
FOREST HILLS, NY 11375
Social Worker (Clinical)
10326 68TH RD
FOREST HILLS, NY 11375
Social Worker
10326 68TH RD
FOREST HILLS, NY 11375
Clinic/Center (Mental Health (Including Community Mental Health Center))
10326 68TH RD
FOREST HILLS, NY 11375

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 Carla Jack's NPI number?

The NPI number for Carla Jack is 1780050807. It was assigned to this individual provider in the NPPES registry on August 12, 2015.

Where is Carla Jack located?

Carla Jack practices at 10326 68th Rd, Forest Hills, NY 11375. The listed phone number is (718) 261-3330.

What is Carla Jack's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Is Carla Jack enrolled in Medicare?

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

What insurance does Carla Jack accept?

Health plans from Blue Cross and Blue Shield of Texas and Providence Health Plan list Carla 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 Carla Jack was last updated on January 31, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.