KATE JACK (NPI# 1588216048) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588216048 |
| Entity Type | Individual |
| Full Name | KATE JACK |
| Credential | MA, LLPC |
| Practice Address |
3351 Claystone St Se Ste G32 Grand Rapids MI 49546-5794 |
| Mailing Address |
558 Locust Ave Se Grand Rapids MI 49506-3010 |
| Practice Telephone | 6162596827 |
| Mailing Telephone | 6162604597 |
| Enumeration Date | 2019-07-15 |
| Last Update Date | 2019-07-15 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YP2500X |
Counselor Specialization: Professional |
6401017481 | MI | Behavioral Health & Social Service Providers |
| Street Address |
3351 CLAYSTONE ST SE STE G32 |
| City | GRAND RAPIDS |
| State | MI |
| Zip Code | 49546-5794 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720602857 | Andria Bremer Savara | Counselor | 3351 Claystone St Se Ste G32, Grand Rapids, MI 49546-5794 | 2020-06-04 |
| 1083247274 | Andria Dalana Lyons | Counselor | 3351 Claystone St Se Ste G32, Grand Rapids, MI 49546-5794 | 2020-02-17 |
| 1972153682 | Justin Benjamin Mccoy | Counselor | 3351 Claystone St Se Ste G32, Grand Rapids, MI 49546-5794 | 2019-09-14 |
| 1003462961 | Ashleigh Prelesnik | Social Worker | 3351 Claystone St Se Ste G32, Grand Rapids, MI 49546-5794 | 2019-08-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437762986 | Amanda Mae Ostrom | Speech-Language Pathologist | 710 Kenmore Ave Se, #110, Grand Rapids, MI 49546 | 2020-08-25 |
| 1063075562 | Kelly Lynn Ibarra | Counselor | 4467 Cascade Road Se, Suite #4479, Grand Rapids, MI 49546 | 2019-04-19 |
| 1891257036 | Jessica Matthews LLC | Counselor | 4127 Embassy Drive Se, Grand Rapids, MI 49546 | 2019-04-05 |
| 1326518531 | Neah Morgan | Technician | 4220 Burton St Se, Grand Rapids, MI 49546 | 2018-11-29 |
| 1316430267 | Michael John Benskey | Case Manager/Care Coordinator | 4065 Saladin St Se, Grand Rapids, MI 49546 | 2018-06-14 |
| 1679062772 | Smile Cascade, P.C. | Clinic/Center | 4505 Cascade Rd Se # A, Grand Rapids, MI 49546 | 2018-05-03 |
| 1720583289 | Jeromy Krogman | Counselor | 826 Parchment Drive Se, Grand Rapids, MI 49546 | 2018-03-27 |
| 1841792660 | Affordable Hearing Clinic | Hearing Instrument Specialist | 833 Kenmoor Ave Se Ste G, Grand Rapids, MI 49546 | 2018-03-07 |
| 1689176133 | Kelly Pines | Physical Therapist | 625 Kenmoor Ave Suite 306, Grand Rapids, MI 49546 | 2018-03-01 |
| 1467971440 | Deanna Elizabeth Saenz | Social Worker | 2100 Raybrook St Se Ste 300, Grand Rapids, MI 49546 | 2017-09-12 |
| Find all providers in zip 49546 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164020558 | Danita Mcalister | Counselor | 2504 Normandy Dr Se Apt 213b, Grand Rapids, MI 49506-7901 | 2020-10-16 |
| 1013521574 | Megan Flier | Counselor | 3744 Bradford St Ne, Grand Rapids, MI 49525-3325 | 2020-09-02 |
| 1457962078 | Cappon Consulting LLC | Counselor | 1344 Mayfield Ave Ne, Grand Rapids, MI 49505-5525 | 2020-08-17 |
| 1124644596 | Travis James Atkinson | Counselor | 3000 Wausaukee Dr Ne, Grand Rapids, MI 49525-1916 | 2020-06-22 |
| 1639790207 | Tracey Wicks | Counselor | 78 Centerbrook St Se, Grand Rapids, MI 49548-6902 | 2020-05-05 |
| 1174160592 | Lindsey Elizabeth Rosa | Counselor | 845 5th St Nw Apt 2, Grand Rapids, MI 49504-5163 | 2019-12-04 |
| 1710530597 | New Way Counseling LLC | Counselor | 1971 E Beltline Ave Ne Ste C, Grand Rapids, MI 49525-7045 | 2019-07-19 |
| 1104488105 | Travis Gordon | Counselor | 800 Monroe Ave Nw Ste 319, Grand Rapids, MI 49503-1451 | 2019-07-01 |
| 1255996575 | The Family Therapy Place Pllc | Counselor | 731 Front Ave Nw, Grand Rapids, MI 49504-5366 | 2019-05-02 |
| 1063075562 | Kelly Lynn Ibarra | Counselor | 4467 Cascade Road Se, Suite #4479, Grand Rapids, MI 49546 | 2019-04-19 |
| Find all providers in GRAND RAPIDS | ||||
| City | GRAND RAPIDS |
| Zip Code | 49546 |
Please comment or provide details below to improve the information on KATE JACK.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.