Individual provider Active NPI

Jessica Williams, LPC

  • Professional Counselor
  • Powell, WY
National Provider Identifier
1073979076
Registry record updated Jun 1, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Practice address
1106 Julie LN
Powell, WY 82435-1632
Phone
(307) 271-7460
NPI assigned
Jan 6, 2016
Last updated
Jun 1, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X Primary

Addresses

Primary practice location

1106 Julie LN
Powell, WY 82435-1632

Mailing address

2110 Peake Ave
Cody, WY 82414-4919
Phone (575) 770-3906

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240531001037 WY Practitioner - Mental Health Counselor 1254786346 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Open Space Counseling Services LLCGroup PAC ID 6800241993, 3 clinicians

Practice addresses (Care Compare)

1501 Stampede Ave
Suite 2058
Cody, WY 82414-4728
Phone (307) 272-2534

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Open Space Counseling Services LLC CurrentSince Mar 17, 2024 Accepting new patients
Northwest Wyoming Treatment Center Past Accepting new patients

Locations

1501 Stampede Ave
Ste 2058
Cody, WY 82414
Phone (307) 250-6852

956 12th St
Cody, WY 82414
Phone (307) 355-9266

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1452038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464739200000",
    "number": "1073979076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2110 PEAKE AVE",
            "city": "CODY",
            "state": "WY",
            "postal_code": "824144919",
            "telephone_number": "575-770-3906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1106 JULIE LN",
            "city": "POWELL",
            "state": "WY",
            "postal_code": "824351632",
            "telephone_number": "307-271-7460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "JESSICA",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-06",
        "last_updated": "2016-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Powell, WY

Sources for this page

Verify at the official NPI Registry.