Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Jack Formanek, MS, LMHP

Individual provider Mental Health Counselor · NPI 1285791376

Jack Formanek, MS, LMHP is a Mental Health Counselor in Council Bluffs, Iowa. Graduated from Nebraska College of Medicine in 1992, 34 years ago. Practices as a sole proprietor and accepts Medicare assignment. Licensed in Iowa.

Years since qualifying
34
Trained at
Nebraska College of Medicine
Licensed in
IA
In the registry since
2007
What do these letters mean?
MS — Master of Science
A graduate science degree.

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Practice location Address checks out

307 E View Dr
Council Bluffs, IA 51503-0464
Phone: (712) 325-1584
Fax: (712) 325-0546
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Mental Health Counselor (primary) Taxonomy 101YM0800X · Licence 205 (IA)

Record details

NPI number1285791376
Entity typeIndividual (Type 1)
GenderMale
Credentials MS , LMHP
Sole proprietorYes
NPI enumeratedJanuary 2, 2007
Last updated in NPPESJuly 8, 2007
Mailing address307 E View Dr, Council Bluffs, IA 51503-0464

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyMENTAL HEALTH COUNSELOR
Medical schoolNEBRASKA COLLEGE OF MEDICINE
Graduated 1992 (34 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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