Jimmy D Widener, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

VA0701003500 Issued in VA

Practice address

Rte 19 - 460
Cedar Bluff, VA 24609

Phone

(276) 964-6702

Fax

(276) 964-5669

NPI assigned

Jun 8, 2006

Last updated

Jul 13, 2026By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in VA

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

Specialty

Mental Health Counselor

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Cumberland Mountain Community ServicesGroup PAC ID 2466355300, 12 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• Cumberland Mountain Community Services

  • Community/Behavioral Health Agency
  • Cedar Bluff, VA
  • NPI 1235125055
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1386684215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 810",
            "city": "CEDAR BLUFF",
            "state": "VA",
            "postal_code": "24609",
            "telephone_number": "276-964-6702",
            "fax_number": "276-964-5669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "RTE 19 - 460",
            "city": "CEDAR BLUFF",
            "state": "VA",
            "postal_code": "24609",
            "telephone_number": "276-964-6702",
            "fax_number": "276-964-5669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIDENER",
        "first_name": "JIMMY",
        "middle_name": "D",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-08",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "VA",
            "license": "VA0701003500",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "278380",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Anna Christine Wess, FNP-C
• Jennifer Justice White, PHARM.D.
• Patti Diane White, LPC, LSATP, CSAC
• Timothy Eugene White, LPC
• Tammy Darlene Whited, BS
• Chris Williams, ATC
• William H Wisener IV, LPC

• Professional Counselor in Cedar Bluff, VA
• Providers in Cedar Bluff, VA by specialty
• Professional Counselor in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.