Waxing Crescent Counseling, LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

WAXING CRESCENT COUNSELING, LLC

Practice address

183 Rocky RDG
St Johnsbury, VT 05819-8850

Phone

(802) 227-7255

NPI assigned

Jan 16, 2023

Last updated

Apr 16, 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

Jordan Timmons, LPCC. LCMHCNPI 1821647546

Title

Co-Owner

Phone

(802) 227-7255

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in VT

Enrollment records 1

Practitioners 2

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.

• Jordan Timmons, LPCC

  • Counselor
  • Saint Paul, MN
  • NPI 1821647546

  VT

  Medicare reassignment NPD Authorized official
• Kaymo Timmons

  • Mental Health Counselor
  • St Johnsbury, VT
  • NPI 1275863094
  Medicare reassignment NPD

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

{
    "created_epoch": "1673827200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713225600000",
    "number": "1205541133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "183 ROCKY RDG",
            "city": "ST JOHNSBURY",
            "state": "VT",
            "postal_code": "058198850",
            "telephone_number": "802-227-7255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "183 ROCKY RDG",
            "city": "ST JOHNSBURY",
            "state": "VT",
            "postal_code": "058198850",
            "telephone_number": "802-227-7255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAXING CRESCENT COUNSELING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-16",
        "last_updated": "2024-04-16",
        "certification_date": "2023-01-15",
        "status": "A",
        "authorized_official_last_name": "TIMMONS",
        "authorized_official_first_name": "JORDAN",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "802-227-7255",
        "authorized_official_credential": "LPCC. LCMHC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Walgreen Co (Walgreens #18090)
• Emily Walsh
• Angela J Walters, LICSW
• Watson Integrated Family Medicine
• Sabine Watson, APRN
• Stephen Dale Waye, LMFT
• Alicia Webb
• Karen Christine Webb, LPN
• Rebecca Wehrenberg, MS
• Tyler Welles, DPT

• Mental Health Counselor in St Johnsbury, VT
• Providers in St Johnsbury, VT by specialty
• Mental Health Counselor in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 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.