Individual provider · Type 1 NPI

Jack Formanek, MS, LMHP

Mental Health Counselor · Council Bluffs, IA

NPI number 1285791376 Active

Practice location

307 E View Dr
Council Bluffs, IA 51503-0464

Call (712) 325-1584 Map

Fax (712) 325-0546

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800X205 (IA)

Mental Health Counselor: Definition to come...

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About NPI 1285791376

Jack Formanek, MS, LMHP's National Provider Identifier is 1285791376, issued on Jan 2, 2007. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Council Bluffs, IA. The record was last updated on Jul 8, 2007.