Jackson Peak Counseling, PLLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

JACKSON PEAK COUNSELING, PLLC

Doing business as

Jackson Peak Counseling, PLLC

Practice address

143 Church St
Dorset, VT 05251-2001

Phone

(802) 445-5703

NPI assigned

May 1, 2024

Last updated

May 1, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Stephen R Longley, LICSWNPI 1417628686

Title

Principal

Phone

(802) 445-5703

Specialties & licenses 1

Addresses

Other names 1

• Jackson Peak Counseling, PLLC Doing business as

Medicare fee-for-service enrollment

Enrolled in VT

Enrollment records 1

Locations

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.

• Stephen R Longley, LCSW

  • Clinical Social Worker
  • Dorset, VT
  • NPI 1417628686
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1714521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714521600000",
    "number": "1194572818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 56",
            "city": "DORSET",
            "state": "VT",
            "postal_code": "052510056",
            "telephone_number": "802-445-5703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "143 CHURCH ST",
            "city": "DORSET",
            "state": "VT",
            "postal_code": "052512001",
            "telephone_number": "802-445-5703"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3624 Main St Ste 401",
            "address_purpose": "LOCATION",
            "city": "Manchester",
            "state": "VT",
            "postal_code": "052544135",
            "country_code": "US",
            "telephone_number": "028-445-5703",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "JACKSON PEAK COUNSELING, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-01",
        "last_updated": "2024-05-01",
        "certification_date": "2024-05-01",
        "status": "A",
        "authorized_official_last_name": "LONGLEY",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRINCIPAL",
        "authorized_official_telephone_number": "802-445-5703",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LICSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jackson Peak Counseling, PLLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kelly Raye Gaiotti, PT, DPT, OCS
• Carolyn Goodwin, NP
• Green Mountain House Calls, LLC
• Miguel Guardado Avelar
• Bradford Marshall Hammond, LCMHC
• Judith M Kernodle, MD
• Jody Lee Knapp, DC
• Stephen R Longley, LCSW
• Patricia A Michl, MS, CCC-SLP
• Ewa S Mosiej-Polkosnik, RPH

• Clinical Social Worker in Dorset, VT
• Providers in Dorset, VT by specialty
• Clinical Social Worker in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.