Organization Active NPI

Headwaters Mental Health and Wellness LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Jackson, WY
National Provider Identifier
1184535064
Registry record updated Sep 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
HEADWATERS MENTAL HEALTH AND WELLNESS LLC
Practice address
690 S Hwy 89 Ste 201
Jackson, WY 83001-8508
Phone
(307) 264-0628
NPI assigned
Sep 17, 2026
Last updated
Sep 17, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2026

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

Authorized official

Name
Eve Grinnell Barnett, PMHNPNPI 1659887297
Title
Owner
Phone
(503) 505-1468

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

690 S Hwy 89 Ste 201
Jackson, WY 83001-8508

Mailing address

PO Box 1243
Jackson, WY 83001-1243
Phone (307) 264-0628

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1789603200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1789603200000",
    "number": "1184535064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1243",
            "city": "JACKSON",
            "state": "WY",
            "postal_code": "830011243",
            "telephone_number": "307-264-0628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "690 S HWY 89 STE 201",
            "city": "JACKSON",
            "state": "WY",
            "postal_code": "830018508",
            "telephone_number": "307-264-0628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEADWATERS MENTAL HEALTH AND WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-09-17",
        "last_updated": "2026-09-17",
        "certification_date": "2026-09-16",
        "status": "A",
        "authorized_official_last_name": "BARNETT",
        "authorized_official_first_name": "EVE",
        "authorized_official_middle_name": "GRINNELL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "503-505-1468",
        "authorized_official_credential": "PMHNP"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, WY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.