Individual provider · Type 1 NPI

Carla Jack, LMHC

Mental Health Counselor · Forest Hills, NY

NPI number 1780050807 Active

Practice location

10326 68th Rd
Forest Hills, NY 11375-3200

Mailing address

14021 Coombs St
Springfield Gardens, NY 11413-2675

Other practice locations

  • 209 Jamaica Ave # 11, Brooklyn, NY 11207-2053 · (718) 309-7935

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor 101YM0800X010630 (NY)
Mental Health Counselor Primary 101YM0800XNone listed

Mental Health Counselor: Definition to come...

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About NPI 1780050807

Carla Jack, LMHC's National Provider Identifier is 1780050807, issued on Aug 12, 2015. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Forest Hills, NY. The record was last updated on Jan 31, 2025.