Jenna Stack, LCMHC-A, LCAS-A

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

A14431 Issued in NC

Practice address

2806 Reynolda Rd Ste 257
Winston Salem, NC 27106-3102

Phone

(336) 223-6700

NPI assigned

Oct 22, 2018

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• New Day High Point, PLLC

  • Mental Health Counselor
  • High Point, NC
  • NPI 1306331244
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1540166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645142400000",
    "number": "1174099790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2806 REYNOLDA RD STE 257",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271063102",
            "telephone_number": "336-223-6700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2806 REYNOLDA RD STE 257",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271063102",
            "telephone_number": "336-223-6700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STACK",
        "first_name": "JENNA",
        "credential": "LCMHC-A, LCAS-A",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-10-22",
        "last_updated": "2022-02-18",
        "certification_date": "2022-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "LCAS-24745",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NC",
            "license": "A14431",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Hart St. John, M.D.
• John St.Angelo III
• Robin Susanne St.Clair, PA
• Carey Vastine Stabler, MD
• Richard Brandon Stacey, M.D.
• Farren A Stackhouse, PH.D., LCMHC, LPC
• Warren D Stacks, MD
• Danielle Emily Stadler, PA-C
• Karyn Stagg, CRNA
• Lura W Stagg, M.D.

• Professional Counselor in Winston Salem, NC
• Providers in Winston Salem, NC by specialty
• Professional Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.