Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Jeremy Wallace Jack, LCPC

Individual provider Case Manager/Care Coordinator · NPI 1396039897

Jeremy Wallace Jack, LCPC is a Mental Health Counselor in Billings, Montana. Qualified in 2021, 5 years ago. Practices with Crossway Incorporated, a 6-clinician group and accepts Medicare assignment. Licensed in Montana.

Years since qualifying
5
Licensed in
MT
In the registry since
2011
Specialties on file
3
What do these letters mean?
LCPC — Licensed Clinical Professional Counselor
A licensed clinical counsellor.

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Practice location Address checks out

1411 Main St Ste B-C
Billings, MT 59105-1712
Phone: (406) 606-9552
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Counselor (primary) Taxonomy 101Y00000X · Licence 31177 (MT)
Case Manager/Care Coordinator Taxonomy 171M00000X
Community Health Worker Taxonomy 172V00000X

Record details

NPI number1396039897
Entity typeIndividual (Type 1)
GenderMale
Credentials LCPC
Sole proprietorNo
NPI enumeratedJune 2, 2011
Last updated in NPPESAugust 31, 2020
Certification dateAugust 31, 2020

Medicare enrollment

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

Medicare specialtyMENTAL HEALTH COUNSELOR
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Crossway Incorporated — 6 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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