Individual provider Active NPI

Paige Johnston, PPC

  • Mental Health Counselor
  • Jackson, WY
National Provider Identifier
1124712294
Registry record updated Jun 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
PPC-1390 Issued in WY
Practice address
140 E Broadway Ave Ste B-13
Jackson, WY 83001-8632
Phone
(307) 413-8393
NPI assigned
Jun 2, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 2, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X PPC-1390 WY Primary

Addresses

Primary practice location

140 E Broadway Ave Ste B-13
Jackson, WY 83001-8632

Mailing address

1200 Melody Creek LN
Jackson, WY 83001-8982
Phone (307) 413-8393

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
I20250415003805 WY Practitioner - Mental Health Counselor 7810412541 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
La Familia Counseling ServicesGroup PAC ID 3375967987, 2 clinicians

Practice addresses (Care Compare)

10 Pioneer LN
Suite 11
Jackson, WY 83001-8175
Phone (307) 413-8393

140 E Broadway Ave
Suite B 13
Jackson, WY 83001-8632
Phone (307) 413-6528

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PPC-1390WYMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
La Familia Counseling Services CurrentSince Mar 11, 2025 Accepting new patients
Teton Crest Counseling LLC Mental Health CurrentSince Jun 4, 2023 Accepting new patients
La Familia Counseling Services Past Accepting new patients

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1685664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685664000000",
    "number": "1124712294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 MELODY CREEK LN",
            "city": "JACKSON",
            "state": "WY",
            "postal_code": "830018982",
            "telephone_number": "307-413-8393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 E BROADWAY AVE STE B-13",
            "city": "JACKSON",
            "state": "WY",
            "postal_code": "830018632",
            "telephone_number": "307-413-8393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSTON",
        "first_name": "PAIGE",
        "credential": "PPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-06-02",
        "last_updated": "2023-06-02",
        "certification_date": "2023-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WY",
            "license": "PPC-1390",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, WY

Sources for this page

Verify at the official NPI Registry.