Lauren Michelle Jack, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LPC15565 Issued in AZ

Practice address

14300 N Northsight Blvd Ste 218
Scottsdale, AZ 85260-3677

Phone

(602) 359-3333

NPI assigned

Nov 7, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Mrs. Lauren Michelle Jack Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1510012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1510012800000",
    "number": "1184137697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25248 N BRONCO TRL",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852552142",
            "telephone_number": "602-359-3333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14300 N NORTHSIGHT BLVD STE 218",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852603677",
            "telephone_number": "602-359-3333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACK",
        "first_name": "LAUREN",
        "middle_name": "MICHELLE",
        "name_prefix": "Mrs.",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-11-07",
        "last_updated": "2017-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "AZ",
            "license": "LPC15565",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAUREN",
            "last_name": "JACK",
            "middle_name": "MICHELLE",
            "prefix": "MRS.",
            "credential": "LPC",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Ellie Izzo, PHD
• Izzy Medical Trans LLC
• J. Michael Foley D.D.S., P.C.
• J.C. Berardi Incorporated
• Jamye Jack, PRSS
• Alexis Lyn Jackson, RBT
• Amy Jackson, MA, LPC
• Desirae Jackson
• Jada Jackson, FNP-BC
• Jane Jackson, RN

• Professional Counselor in Scottsdale, AZ
• Providers in Scottsdale, AZ by specialty
• Professional Counselor in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2017; 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.