Carla Jack, MHC in Forest Hills, NY - Medicare Counselor Provider

Carla Jack, MHC is a medicare enrolled "Counselor - Mental Health" provider in Forest Hills, New York. Her current practice location is 10326 68th Rd, Forest Hills, New York. You can reach out to her office (for appointments etc.) via phone at (718) 261-3330.

Carla Jack is licensed to practice in * (Not Available) (license number ) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1780050807.

Contact Information

	Carla Jack, MHC
	10326 68th Rd, Forest Hills, NY 11375-3200
	(718) 261-3330
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Carla Jack
Gender	Female
Speciality	Counselor - Mental Health
Location	10326 68th Rd, Forest Hills, New York
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1780050807
Provider Enumeration Date: 08/12/2015
Last Update Date: 10/03/2022

Medicare PECOS Information:

PECOS PAC ID: 4688010143
Enrollment ID: I20240307000961

Medical Identifiers

Medical identifiers for Carla Jack such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1780050807	NPI	-	NPPES
634459630	Other	NY	NYS ID

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
101YM0800X	Counselor - Mental Health	(* (Not Available))	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Carla Jack allows following entities to bill medicare on her behalf.

Entity Name	Flushing Hospital & Medical Center
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1548217763 PECOS PAC ID: 2668367483 Enrollment ID: O20040219000415

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Carla Jack is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Carla Jack, MHC 14021 Coombs St, Springfield Gardens, NY 11413-2675 Ph: (929) 385-6765	Carla Jack, MHC 10326 68th Rd, Forest Hills, NY 11375-3200 Ph: (718) 261-3330

Reviews and Comments

Counselor in Forest Hills, NY

Ms. Cecelia M Telsey, M.S. Counselor Medicare: Not Enrolled in Medicare Practice Location: 6766 108 Street, D-11, Forest Hills, NY 11375 Phone: 718-575-1035
Marisol Flores-ortega, Counselor Medicare: Not Enrolled in Medicare Practice Location: 11835 Queens Blvd Ste 400, Forest Hills, NY 11375 Phone: 646-656-0164
Jessica Macdonald, Counselor Medicare: Not Enrolled in Medicare Practice Location: 10470 Queens Blvd, Suite 200, Forest Hills, NY 11375 Phone: 718-275-6010 Fax: 718-275-6062
Shaina Lauren Beshkin, MHC-LP Counselor Medicare: Not Enrolled in Medicare Practice Location: 10235 64th Rd Unit Gf, Forest Hills, NY 11375 Phone: 917-565-9961
Adam Rosen, M.A. Counselor Medicare: Not Enrolled in Medicare Practice Location: 10470 Queens Blvd, Suite 200, Forest Hills, NY 11375 Phone: 718-275-6010 Fax: 718-275-6062
Liping Zhang, LCSW-R Counselor Medicare: Not Enrolled in Medicare Practice Location: 7011 108th St Apt 3e, Forest Hills, NY 11375 Phone: 917-566-8968
Yuanjing Wang, Counselor Medicare: Not Enrolled in Medicare Practice Location: 10460 Queens Blvd Apt 4n, Forest Hills, NY 11375 Phone: 551-344-7149

Carla Jack, MHC - Medicare Counselor in Forest Hills, NY