Active NPI
Ashley Jessica Mack
- Mental Health Counselor
- Salem, OR
National Provider Identifier
1346746658
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 1520 Plaza St NW Ste 150
Salem, OR 97304-4658 - Phone
- (503) 585-3012
- NPI assigned
- Apr 4, 2018
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | Primary |
Addresses
Primary practice location
1520 Plaza St NW Ste 150
Salem, OR 97304-4658
Mailing address
11424 SW Bull Mountain Rd Apt 314
Tigard, OR 97224-2979
Phone (408) 483-5585
Other practice location 1
182 SW Academy St Ste 333
Dallas, OR 97338-1996
Phone (503) 623-9289
Other practice location 2
1310 Main St E
Monmouth, OR 97361-1722
Phone (503) 400-3550
Other names 1
- Jessica Mack
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| County of Polk | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- State or Local Public Health Clinic/Center
- Dallas, OR
- NPI 1710910781
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1522800000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1522800000000",
"number": "1346746658",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11424 SW BULL MOUNTAIN RD APT 314",
"city": "TIGARD",
"state": "OR",
"postal_code": "972242979",
"telephone_number": "408-483-5585"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1520 PLAZA ST NW STE 150",
"city": "SALEM",
"state": "OR",
"postal_code": "973044658",
"telephone_number": "503-585-3012"
}
],
"practiceLocations": [
{
"address_1": "182 SW Academy St Ste 333",
"address_purpose": "LOCATION",
"city": "Dallas",
"state": "OR",
"postal_code": "973381996",
"country_code": "US",
"telephone_number": "503-623-9289",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1310 Main St E",
"address_purpose": "LOCATION",
"city": "Monmouth",
"state": "OR",
"postal_code": "973611722",
"country_code": "US",
"telephone_number": "503-400-3550",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MACK",
"first_name": "ASHLEY",
"middle_name": "JESSICA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-04-04",
"last_updated": "2018-04-04",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "JESSICA",
"last_name": "MACK",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Salem, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.