Jefferson Clinton Willis, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

L8-0010827 Issued in DE

Practice address

413 High St
Seaford, DE 19973-3923

Phone

(302) 394-6051

NPI assigned

Apr 17, 2025

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in DE

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2025

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Compass Mental Wellness Services, IncGroup PAC ID 9739522384, 8 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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 and National Provider Directory roles.

• Compass Mental Wellness Services, Inc

  • Psychologist
  • Seaford, DE
  • NPI 1174137624
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1744848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744848000000",
    "number": "1417743113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28425 CEDAR RIDGE DR",
            "city": "MILLSBORO",
            "state": "DE",
            "postal_code": "199662709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "413 HIGH ST",
            "city": "SEAFORD",
            "state": "DE",
            "postal_code": "199733923",
            "telephone_number": "302-394-6051"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "28425 Cedar Ridge Dr",
            "address_purpose": "LOCATION",
            "city": "Millsboro",
            "state": "DE",
            "postal_code": "199662709",
            "country_code": "US",
            "telephone_number": "479-387-0995",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLIS",
        "first_name": "JEFFERSON",
        "middle_name": "CLINTON",
        "credential": "PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-04-17",
        "last_updated": "2025-04-17",
        "certification_date": "2025-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "DE",
            "license": "L8-0010827",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Abby Frances Wilkerson, RN
• Jeffrey Allan Willey, PHD, PMHNP-BC
• Laurie Williams, BS,CADC
• Virginia Willing, R.N.
• Jennifer Willis-Lal, DPT
• Ny'Ja Winder
• Marie C Wolfgang, M.D.
• Women'S Medical Center, P.a.
• Brenda Lynn Wood, P.T.A
• Tiffany Ann Woodall, PTA

• Psychiatric/Mental Health Nurse Practitioner in Seaford, DE
• Providers in Seaford, DE by specialty
• Psychiatric/Mental Health Nurse Practitioner in Delaware

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2025; 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.