Lisa Jack
Behavior Technician in Minersville, PA. Individual provider (NPI-1).
NPI number1922645035
StatusActive
Last updated in NPPESDec 9, 2019
Details
- NPI
- 1922645035
- Entity type
- Individual (NPI-1)
- Name
- Lisa Jack
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Dec 9, 2019
- Certification date
- Dec 9, 2019
- Last updated
- Dec 9, 2019
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 106S00000X | Behavior Technician | – | – | Yes |
Practice location
2880 Pottsville Minersville Hwy # 135Minersville, PA 17954-2027
Phone 610-831-1865 · Fax 615-577-5654
Mailing address
1321 Murfreesboro Pike Ste 702Nashville, TN 37217-2679
Phone 844-359-7629 · Fax 615-577-5654
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
Other Behavior Technician providers in Minersville, PA
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All 15 Behavior Technician providers in Minersville · All 70 providers in Minersville
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