JACQUELINE MACK (NPI# 1750940821) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750940821 |
| Entity Type | Individual |
| Full Name | JACQUELINE MACK |
| Practice Address |
1005 S Central Ave Los Angeles CA 90021-2039 |
| Practice Telephone | 2135331050 |
| Mailing Telephone | 2135331050 |
| Enumeration Date | 2019-06-11 |
| Last Update Date | 2019-06-11 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101Y00000X | Counselor | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669737789 | Jacqueline A Mack | Social Worker | 2001 W Blue Heron Blvd, Riviera Beach, FL 33404-5003 | 2012-07-05 |
| 1508162934 | Jacqueline K Mack | Counselor | 2111 River Valley Dr, Spring, TX 77373-6396 | 2011-02-02 |
| 1114046687 | Jacqueline Mack | Counselor | 215 Commerce St, Manning, SC 29102-2638 | 2007-03-28 |
| Street Address |
1005 S CENTRAL AVE |
| City | LOS ANGELES |
| State | CA |
| Zip Code | 90021-2039 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174696033 | Catalina Flick | Registered Nurse | 1005 S Central Ave, Los Angeles, CA 90021-2039 | 2006-11-16 |
| 1780055848 | Dayveon Shawver | Marriage & Family Therapist | 1005 S Central Ave, Los Angeles, CA 90021-2039 | 2015-10-15 |
| 1083002398 | Geovanni Romero | Case Manager/Care Coordinator | 1005 S Central Ave, Los Angeles, CA 90021-2039 | 2015-01-08 |
| 1912313818 | Mikhail Tonkonogy | Case Manager/Care Coordinator | 1005 S Central Ave, Los Angeles, CA 90021-2039 | 2014-07-11 |
| 1861806671 | Kristina Lieu | Case Manager/Care Coordinator | 1005 S Central Ave, Los Angeles, CA 90021-2039 | 2014-06-19 |
| 1982026522 | Mary Trejo | Case Manager/Care Coordinator | 1005 S Central Ave, Los Angeles, CA 90021-2039 | 2014-01-16 |
| 1083036628 | Darwyn Shaw | Licensed Vocational Nurse | 1005 S Central Ave, Los Angeles, CA 90021-2039 | 2014-01-16 |
| 1477975092 | Christal Sterling | Case Manager/Care Coordinator | 1005 S Central Ave, Los Angeles, CA 90021-2039 | 2014-01-16 |
| 1922349000 | Carlotta Washington | Case Manager/Care Coordinator | 1005 S Central Ave, Los Angeles, CA 90021-2039 | 2013-03-14 |
| 1871831883 | Ali Rahnoma | Case Manager/Care Coordinator | 1005 S Central Ave, Los Angeles, CA 90021-2039 | 2013-01-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386104222 | Para Los Ninos | Community/Behavioral Health | 835 Stanford Avenue, Los Angeles, CA 90021 | 2019-03-25 |
| 1750826293 | Dion David Thomas | Counselor | 600 E 7th Street #105, Los Angeles, CA 90021 | 2016-12-19 |
| 1255713921 | Stephanie Castillo | Counselor | 453 S. Indiana St., Los Angeles, CA 90021 | 2015-06-18 |
| 1700217437 | Gabriela Turcios | Counselor | 2116-2118 S. Central Ave, Los Angeles, CA 90021 | 2013-12-05 |
| 1033456934 | Brenda Denise Perez | Counselor | 838 Est. 6th Treet, Los Angeles, CA 90021 | 2013-01-11 |
| 1083885370 | Dina Moss | Rehabilitation Practitioner | 921 Compton Blv, Compton, CA 90021 | 2008-03-14 |
| 1760692339 | Deanna Perez | Physician Assistant | 515 E. 6th Street, Los Angeles, CA 90021 | 2007-05-23 |
| 1033322573 | Nguyen Trong Doan | Physician Assistant | 1663 Beverly Blvd., #201, Los Angeles, CA 90021 | 2007-05-08 |
| 1740834258 | Janette Lozada | Counselor | 849 E 6th St, Los Angeles, CA 90021 | 2019-08-01 |
| 1588166789 | Roseanna Low | Counselor | 905 E 8th St, Los Angeles, CA 90021 | 2018-03-02 |
| Find all providers in zip 90021 | ||||
| Taxonomy Code | 101Y00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| 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. |
| Notes: Sources: Abridged from definitions provided by the National Board of Certified Counselors and the American Association of Pastoral Counselors. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952913055 | Jose Islas | Counselor | 4396 1/2 Lovett St, Los Angeles, CA 90023-4117 | 2020-08-19 |
| 1154931491 | Delia Maria Cortez | Counselor | 12133 Clarkson Rd, Los Angeles, CA 90064-3519 | 2020-08-02 |
| 1457974263 | Simeon Simov | Counselor | 11845 W Olympic Blvd # 815e, Los Angeles, CA 90064-1149 | 2020-05-27 |
| 1780206524 | Keisha Whitfield | Counselor | 1123 W 7th St # 25, Los Angeles, CA 90017-2409 | 2020-05-14 |
| 1467073965 | Flowlab Inc | Counselor | 4528 Los Feliz Blvd, Los Angeles, CA 90027-2006 | 2020-05-06 |
| 1619504925 | Tanisha N Tatum | Counselor | 5777 W Century Blvd # 11102035, Los Angeles, CA 90045-5600 | 2020-03-25 |
| 1083241988 | Rezolve Telemed | Counselor | 8275 Kirkwood Dr, Los Angeles, CA 90046-1923 | 2020-03-23 |
| 1902439656 | Maria Velazquez | Counselor | 5318 S Crenshaw Blvd, Los Angeles, CA 90043-1810 | 2020-02-20 |
| 1922647569 | Ping Sun | Counselor | 520 S Sepulveda Blvd Ste 200, Los Angeles, CA 90049-3534 | 2019-12-30 |
| 1780233213 | Rafael Martin Perez | Counselor | 5955 Hooper Ave Apt A, Los Angeles, CA 90001-1292 | 2019-09-06 |
| Find all providers in LOS ANGELES | ||||
| City | LOS ANGELES |
| Zip Code | 90021 |
Please comment or provide details below to improve the information on JACQUELINE MACK.
| 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.