Reisha Jack, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

4412 Issued in TN

Practice address

1037 Cresthaven Rd
Memphis, TN 38119-3833

Phone

(901) 682-6136

Fax

(901) 682-7136

NPI assigned

Oct 9, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• Mental Health Resources, PLLC

  • Clinic/Center
  • Germantown, TN
  • NPI 1922034503
  NPD (past)

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

{
    "created_epoch": "1539043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539043200000",
    "number": "1750856522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2231 OAK HOLLOW LN",
            "city": "CORDOVA",
            "state": "TN",
            "postal_code": "380165206",
            "telephone_number": "901-239-4411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1037 CRESTHAVEN RD",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381193833",
            "telephone_number": "901-682-6136",
            "fax_number": "901-682-7136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACK",
        "first_name": "REISHA",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-09",
        "last_updated": "2018-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TN",
            "license": "4412",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• J&M Logistics Inc
• Jaamac Dental
• Tyler Jaap, IDHS
• Yazan Rajai Jabaji, DC
• Michael Jacewicz, MD
• Robin Lynne Jack, MD
• Courtney Jacks, MS, CCC-SLP
• Jackson Transportation
• Adrienne Maxine Jackson-Payne, D.D.S.
• Jackson-Randle Family Healthcare, P.L.C.

• Professional Counselor in Memphis, TN
• Providers in Memphis, TN by specialty
• Professional Counselor in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 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.

Verify at the official NPI Registry.