JESSICA K. PACK (NPI# 1205119575) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205119575 |
| Entity Type | Individual |
| Full Name | JESSICA K. PACK |
| Credential | MHA, MS, LGC |
| Practice Address |
4330 Glenview Avenue #111 Glenview KY 40025-0111 |
| Mailing Address |
Po Box 3139 Corydon IN 47112-3139 |
| Practice Telephone | 8882522842 |
| Practice Fax Number | 5024703645 |
| Mailing Telephone | 8882522842 |
| Mailing Fax Number | 5024703645 |
| Enumeration Date | 2011-09-23 |
| Last Update Date | 2018-04-24 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 170300000X | Genetic Counselor, MS | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | GENETIC COUNSELING LICENSE | 74000172A | 01 |
| NE | GENETIC COUNSELING LICENSE | 96 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 245 W Highway 62 Unit 3139, Corydon, IN 471124552 | 8882522842 | 5024703645 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013365881 | Jessica Yoon Kyung Pack | Dentist | 1234 Wilshire Blvd Apt 212, Los Angeles, CA 90017-1974 | 2016-06-02 |
| 1629609359 | Jessica Pack | Nurse Practitioner | 125 Nationwide Dr, Lynchburg, VA 24502-4272 | 2020-01-31 |
| Street Address |
4330 GLENVIEW AVENUE #111 |
| City | GLENVIEW |
| State | KY |
| Zip Code | 40025-0111 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598004467 | Fitzbugh Xanophon Mullins | Surgery | 4314 Glenview Ave, Glenview, KY 40025-7509 | 2013-02-12 |
| 1154777118 | Advanced Tele-genetic Counseling | Clinic/Center | 4330 Glenview Ave Ste 111, Glenview, KY 40025-9998 | 2016-05-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922607001 | Katherine Chen | Student in an Organized Health Care Education/Training Program | 2305 Mohawk Ln, Glenview, IL 60026-1035 | 2020-10-20 |
| 1902413537 | Citadel of Glenview LLC | Skilled Nursing Facility | 1700 E Lake Ave, Glenview, IL 60025-2003 | 2020-09-28 |
| 1912514654 | Marlon Viloria | Registered Nurse | 4557 Jenna Rd, Glenview, IL 60025-1403 | 2020-09-27 |
| 1093322091 | Aven Dones | Occupational Therapy Assistant | 2600 W Compass Dr, Glenview, IL 60026 | 2020-09-24 |
| 1134733835 | Bethany North Suburban Group | Home Health | 2601 Chestnut Ave Unit 3310, Glenview, IL 60026-8317 | 2020-09-01 |
| 1275147084 | Shaily Desai | Physical Therapist | 1879 Chestnut Ave, Glenview, IL 60025-1602 | 2020-08-31 |
| 1528670692 | Help and Healing Center LLC | Psychologist | 2500 Patriot Boulevard, Suite 250, Glenview, IL 60026 | 2020-08-20 |
| 1912516659 | Northwestern Medical Faculty Foundation | Optometrist | 2701 Patriot Blvd Fl 2, Glenview, IL 60026-8039 | 2020-07-29 |
| 1760009872 | Eric Gartner | Pharmacist | 2318 Swainwood Dr, Glenview, IL 60025-2742 | 2020-07-06 |
| 1316564784 | Michael A Barth | Dentist | 1735 Wildberry Dr Unit A, Glenview, IL 60025-1741 | 2020-07-01 |
| Find all providers in GLENVIEW | ||||
| Taxonomy Code | 170300000X |
| Grouping | Other Service Providers |
| Classification | Genetic Counselor, MS |
| A masters trained health care provider who collects and interprets genetic family histories; assesses the risk of disease occurrence or recurrence; identifies interventions to manage or ameliorate disease risk; educates about inheritance, testing, management, prevention, ethical issues, resources, and research; and counsels to promote informed choices and adaptation. Certification was established in 1993 by the American Board of Genetic Counseling and prior to that by the American Board of Medical Genetics. Requirements for experience, licensure, and job responsibilities vary among the states. |
| Notes: Source: National Society of Genetic Counselors [7/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912529553 | Rebekah Lynne Waikel | Genetic Counselor, MS | 125 E Maxwell St Ste 200, Lexington, KY 40508-2678 | 2020-05-16 |
| 1093336067 | Keith Hahto | Genetic Counselor, MS | 3999 Dutchmans Ln Ste 1a, Louisville, KY 40207-4741 | 2020-04-30 |
| 1952875882 | Natasha Combs | Genetic Counselor, MS | 125 E Maxwell St Ste 130, Lexington, KY 40508-2678 | 2019-01-14 |
| 1073867479 | Dawn Holladay | Genetic Counselor, MS | 20 Medical Village Dr Ste 212, Edgewood, KY 41017-5405 | 2012-11-07 |
| 1538449343 | Elizabeth Ann Reilly Hays | Genetic Counselor, MS | 3470 Blazer Pkwy Ste 200, Lexington, KY 40509-1887 | 2011-08-24 |
| 1730789132 | Bailey Hancock | Genetic Counselor, MS | 1 Medical Village Dr, Edgewood, KY 41017-3403 | 2020-10-27 |
| 1831799220 | Caroline Ewart | Genetic Counselor, MS | 1 Medical Village Dr, Edgewood, KY 41017-3403 | 2020-10-27 |
| 1114538519 | Carrie Nicole Anderson | Genetic Counselor, MS | 1 Medical Village Dr, Floor 3 - Mfm, Edgewood, KY 41017-4101 | 2020-08-11 |
| 1629686977 | Kennedy Paige Richardson | Genetic Counselor, MS | 411 E Chestnut St, Louisville, KY 40202-1713 | 2020-07-22 |
| 1598383408 | Carlee Michele Grubbs | Genetic Counselor, MS | 234 E Gray St, Louisville, KY 40202-1900 | 2020-07-07 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.