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RICHARD M JACK LCSW-R
NPI 1801803218
Social Worker - Clinical in Ticonderoga, NY

Active since August 01, 2006
102 RACE TRACK RD, TICONDEROGA, NY 12883(518) 585-6708(518) 585-3260 Get Directions Write a Review

NPPES record last updated: February 7, 2017. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Richard M Jack Lcsw-r NPPES

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

RICHARD M JACK LCSW-R (NPI 1801803218) is an individual clinical provider in Ticonderoga, New York, licensed in New York (060855) and active in the NPI registry since August 2006.

NPPES Registry Identity

NPI1801803218
Entity TypeIndividualMale
Primary Taxonomy1041C0700X
Provider Legal NameRICHARD M JACKCredential: LCSW-R
Location Address102 RACE TRACK RDTiconderoga, NY 12883-4004
Mailing Address9 Carey RdQueensbury, NY 12804-7880 · (518) 761-0300 · Fax (518) 824-2388
Phone(518) 585-6708
Fax(518) 585-3260
Sole ProprietorNo
Enumeration DateAugust 1, 2006
Last NPPES UpdateFebruary 7, 2017
✔ NPI 1801803218 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
License✔ Licensed in NY · 060855
Definition
A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
102 RACE TRACK RD, Ticonderoga, NY 12883
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Other Identifiers 3

Medicare PINJ400064894NY
Medicaid03201392NY
Medicare UPINR26898NY

Other Providers at the Same Location NPPES 7

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

MRS. AMY LAPIERRE R.D.
Dietitian, Registered
102 RACE TRACK RD
TICONDEROGA, NY 12883
Essex County (518) 962-4810
GLEN D CHAPMAN MD
Family Medicine
102 RACE TRACK RD, SUITE 1
TICONDEROGA, NY 12883
Essex County (518) 585-6708
KATHLEEN P HUESTIS MD
Family Medicine
102 RACE TRACK RD
TICONDEROGA, NY 12883
Essex County (518) 585-6708
MS. PATRICIA M MCLOUGHLIN NPP
Nurse Practitioner (Psychiatric/Mental Health)
102 RACE TRACK RD, SUITE 1
TICONDEROGA, NY 12883
Essex County (518) 585-6708
OPTICS LTD
Durable Medical Equipment & Medical Supplies
102 RACE TRACK RD, SUITE 3
TICONDEROGA, NY 12883
Essex County (518) 585-4000
WILLIAM R. UNWIN LCSW
Social Worker (Clinical)
102 RACE TRACK RD
TICONDEROGA, NY 12883
Essex County (518) 585-6708
GREGORY W RUNKEL MD
Pediatrics
102 RACE TRACK RD, SUITE 1
TICONDEROGA, NY 12883
Essex County (518) 585-6708

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 Richard Jack's NPI number?

The NPI number for Richard Jack is 1801803218. It was assigned to this individual provider in the NPPES registry on August 1, 2006.

Where is Richard Jack located?

Richard Jack practices at 102 Race Track Rd, Ticonderoga, NY 12883. The listed phone number is (518) 585-6708.

What is Richard Jack's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

When was this NPI record last updated?

The NPPES record for Richard Jack was last updated on February 7, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.