Jonathan Chack, M.A.

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

7572 Issued in MA

Practice address

10 East St
Ayer, MA 01432-1805

Phone

(978) 464-1048

NPI assigned

Jul 27, 2010

Last updated

Jan 14, 2014By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Enrolled in VT

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

Specialty

Mental Health Counselor

Education

Other, 1993

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Group practices

Forensic Consultation and Counseling ServiceGroup PAC ID 2668865205, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

State licenses

Practice roles

Locations

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.

• Forensic Consultation & Counseling Service

  • Addiction (Substance Use Disorder) Counselor
  • Rutland, VT
  • NPI 1083997563

  Mental Health

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1280188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1389657600000",
    "number": "1922312347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 EAST ST",
            "city": "AYER",
            "state": "MA",
            "postal_code": "014321805",
            "telephone_number": "978-464-1048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 EAST ST",
            "city": "AYER",
            "state": "MA",
            "postal_code": "014321805",
            "telephone_number": "978-464-1048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHACK",
        "first_name": "JONATHAN",
        "credential": "M.A.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-07-27",
        "last_updated": "2014-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MA",
            "license": "7572",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Phillip Paul Buchieri II, P.T.
• Victoria Casavecchia, RN, NC-BC
• Paula Centauro, RN
• Central Ma Cardiovascular Physicians Inc
• Adam W Cerel, MD
• Christa L. Maxant, Inc.
• Kelly Colton
• Robyn Coons, LICSW, BCD
• Angelica Marie Costas
• Christina L Cozza

• Mental Health Counselor in Ayer, MA
• Providers in Ayer, MA by specialty
• Mental Health Counselor in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.