Jeremy W. Jack LCPC
Counselor in Billings, MT(View on Map)
Full Name
Jeremy Wallace Jack LCPC
NPI Number
1396039897
NPI Type
Individual Provider
Gender
Male
Enumeration Date
06/02/2011
Specialties
(Taxonomies)Code
101Y00000X
171M00000X
172V00000X
Primary Taxonomy
Yes
No
No
Licenses
State
Montana
License Number
31177
Contact
Information
Purpose
Mailing
Location
Address
1411 MAIN ST # B-C
1411 MAIN ST STE B-C
City
Billings
Billings
State
MT
MT
Postal Code
59105-1712
59105-1712
Country
US
US
Telephone Number
(406) 606-9552
(406) 606-9552
Provider data last refreshed from NPPES NPI registry on 11/19/2024
Data last updated by provider on 08/31/2020
Provider Address
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