Active NPI
Headwaters Mental Health and Wellness LLC
- Psychiatric/Mental Health Nurse Practitioner
- Jackson, WY
National Provider Identifier
1184535064
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- 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, 2026
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Eve Grinnell Barnett, PMHNP
- 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) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 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 DirectoryPractitioners & 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.
-
- Psychiatric/Mental Health Nurse Practitioner
- Phoenix, AZ
- NPI 1659887297
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.