Individual provider Active NPI

Jon Thomas Pesek II, LPC

  • Counselor
  • Helena, AL
National Provider Identifier
1710399704
Registry record updated Mar 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
3568 Issued in AL
Practice address
277 Village Pkwy
Helena, AL 35080-4028
Phone
(205) 624-3076
Fax
(844) 835-1972
NPI assigned
May 23, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 27, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 3568 AL Primary

Addresses

Primary practice location

277 Village Pkwy
Helena, AL 35080-4028

Mailing address

277 Village Pkwy
Helena, AL 35080-4028
Phone (205) 624-3076

Other identifiers 1

IdentifierTypeStateIssuer
182873MedicaidAL

Other names 1

  • Mr. Jay Pesek Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240718003849 AL Practitioner - Mental Health Counselor 3678912821 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2012
Medicare assignment
May accept Medicare assignment
Group practices
Jay Pesek Counseling Services, LLCGroup PAC ID 4082053236, 3 clinicians

Practice addresses (Care Compare)

277 Village Pkwy
Helena, AL 35080-4028
Phone (205) 624-3076

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3568ALMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
Jay Pesek Counseling Services, LLC Counselor CurrentSince Jan 1, 2024 Accepting new patients

Locations

277 Village Pkwy
Helena, AL 35080
Phone (205) 620-5025

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.

NPI Registry JSON

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

{
    "created_epoch": "1400803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711497600000",
    "number": "1710399704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "277 VILLAGE PKWY",
            "city": "HELENA",
            "state": "AL",
            "postal_code": "350804028",
            "telephone_number": "205-624-3076",
            "fax_number": "844-835-1972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "277 VILLAGE PKWY",
            "city": "HELENA",
            "state": "AL",
            "postal_code": "350804028",
            "telephone_number": "205-624-3076",
            "fax_number": "844-835-1972"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PESEK",
        "first_name": "JON",
        "middle_name": "THOMAS",
        "name_prefix": "Mr.",
        "name_suffix": "II",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-05-23",
        "last_updated": "2024-03-27",
        "certification_date": "2024-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "AL",
            "license": "3568",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "182873",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JAY",
            "last_name": "PESEK",
            "prefix": "MR.",
            "credential": "LPC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Helena, AL

Sources for this page

Verify at the official NPI Registry.