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Active NPI 1417308594 Individual Practitioner Male Practitioner

Jesse Tyler Mack , LPC

Counselor - Professional • Clinton, LA

Public Directory Information & Medical Disclaimer

This profile is compiled from official public domain records provided by CMS and the NPPES registry. TRUE-MEDINFO is an independent reference directory and does not provide medical advice, diagnosis, or treatment recommendations. Always consult a licensed medical professional for personal health decisions.

Professional Overview & Biography Verified Profile Summary

Jesse Mack, LPC is a registered healthcare professional specializing in Counselor - Professional in Clinton, LA. Official NPI practice address is registered at 11990 JACKSON ST.

Practice Location & Contact Primary Location

Practice Address

11990 Jackson St

Clinton, LA 70722

Telephone 2256835292
Fax 2256831310
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Counselor - Professional in Clinton, LA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 14.7 Yrs
Regional Practice Density
8 Specialists

Practicing in Clinton, LA (2984 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Counselor - Professional Primary Specialty

NUCC Taxonomy Code: 101YP2500X

State License LA 6784

Definition to come...

Counselor

NUCC Taxonomy Code: 101Y00000X

A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.

Case Manager/Care Coordinator

NUCC Taxonomy Code: 171M00000X

A person who provides case management services and assists an individual in gaining access to needed medical, social, educational, and/or other services. The person has the ability to provide an assessment and review of completed plan of care on a periodic basis. This person is also able to take collaborative action to coordinate the services with other providers and monitor the enrollee's progress toward the cost-effective achievement of objectives specified in the plan of care. Credentials may vary from an experience in the fields of psychology, social work, rehabilitation, nursing or a closely related human service field, to a related Assoc of Arts Degree or to nursing credentials. Some states may require certification in case management.

Additional State Medicaid & Healthcare Payer Identifiers

Commercial Insurance / Payer ID State Of Louisiana Licensed Professional Counselors Board Of Examiners
6784 (LA)

Secondary Practice Locations

30826 Linder Rd

Denham Springs, LA 70726

Phone: 2256657878

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

40 Associated Practitioners
Stella Brown , LCSW, BCSAC

Social Worker - Clinical

NPI 1013066372

Licensed Clinical Social Worker, BCSAC

Wanda Pezant , APRN

Nurse Practitioner - Family

NPI 1013266162

Advanced Practice Registered Nurse

Cassandra Mcphate , RN

Registered Nurse

NPI 1013579663

Registered Nurse

Shantele Butler , LPC-S

Counselor - Professional

NPI 1033588892

LPCS

Sarah Mccarley , LCSW

Social Worker - Clinical

NPI 1053660118

Licensed Clinical Social Worker

Sandra Collins

Registered Nurse

NPI 1063074672

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

12 Historical Events
📍
Updated Practice Location October 31, 2019

Registered at 11990 JACKSON ST, CLINTON, LA 70722 (Tel: 2256835292)

📍
Updated Business Mailing Address October 31, 2019

Registered at PO BOX 395, CLINTON, LA 707220395 (Tel: 2256835292)

👤
Provider Name / Credentials Updated October 31, 2019

Recorded as JESSE MACK, LPC

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) October 03, 2018

Counselor

📍
Updated Practice Location June 08, 2018

Registered at 30826 LINDER RD, DENHAM SPRINGS, LA 70726 (Tel: 2256657878)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) June 08, 2018

Case Manager/Care Coordinator

NPI Profile Active June 29, 2016

NPI status registered as active in NPPES database

📍
Updated Practice Location June 29, 2016

Registered at 30826 LINDER RD, DENHAM SPRINGS, LA 707268507 (Tel: 2256657878)

📍
Updated Business Mailing Address June 29, 2016

Registered at 30826 LINDER RD, DENHAM SPRINGS, LA 707268507 (Tel: 2256657878)

👤
Provider Name / Credentials Updated June 29, 2016

Recorded as JESSE MACK

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) June 29, 2016

Counselor

🟢
Initial NPI Registration & Enumeration June 29, 2016

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1417308594
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: June 29, 2016
Last Update: October 31, 2019
Sole Proprietor: No

Mailing Address

Po Box 395

Clinton, LA 707220395

Phone: 2256835292

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.