Heather Rayan Pack, LPC, ALPS, NCC, AADC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

2466 Issued in WV

Practice address

1718 Wonderland Rd
Fayetteville, WV 25840-5248

Phone

(304) 543-8289

NPI assigned

Sep 6, 2006

Last updated

Jul 15, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: heatherpack@tdh.allscriptsdirect.net

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

• Teladoc Health Medical Group, P.a.

  • Family Medicine Physician
  • Lewisville, TX
  • NPI 1245403567

  Counselor

  NPD

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

{
    "created_epoch": "1157500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626307200000",
    "number": "1487757787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1718 WONDERLAND RD",
            "city": "FAYETTEVILLE",
            "state": "WV",
            "postal_code": "258405248",
            "telephone_number": "304-543-8289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1718 WONDERLAND RD",
            "city": "FAYETTEVILLE",
            "state": "WV",
            "postal_code": "258405248",
            "telephone_number": "304-543-8289"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PACK",
        "first_name": "HEATHER",
        "middle_name": "RAYAN",
        "credential": "LPC, ALPS, NCC, AADC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-06",
        "last_updated": "2021-07-15",
        "certification_date": "2021-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "KY",
            "license": "0360",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WV",
            "license": "2466",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NC",
            "license": "8145S",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30610026",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1487757787",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1487757787",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• New Riverranch
• Ryan D Newell, D.O.
• Debra W Nichol, RPH
• Allie Chinyere Nwosu, MS
• James William Odell
• Sharon Pack, P.T.
• Carl Parsons
• Patrick Jarrell
• Lauren Perez
• Andrew Hunter Petersen, DO

• Professional Counselor in Fayetteville, WV
• Providers in Fayetteville, WV by specialty
• Professional Counselor in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2021; 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.