Jacob Edmondson, MA

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

149 State St Unit 6
Montpelier, VT 05602-2965

Phone

(802) 522-8298

NPI assigned

Oct 23, 2024

Last updated

Oct 23, 2024By the provider in NPPES

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 VT, PA2 enrollments

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 2

Specialty

Mental Health Counselor

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

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.

• Wildwood Therapy Collective LLC

  • Mental Health Counselor
  • Gibsonia, PA
  • NPI 1831989482

  VT

  Medicare reassignment NPD Authorized official
• Edmondson Counseling Services LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Montpelier, VT
  • NPI 1679397699
  NPD Authorized official
• Edmondson Counseling Services LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Montpelier, VT
  • NPI 1881495596
  NPD Authorized official

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

{
    "created_epoch": "1729641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729641600000",
    "number": "1477374379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28 RIDGEWOOD TER",
            "city": "BARRE",
            "state": "VT",
            "postal_code": "056419738",
            "telephone_number": "802-522-9211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "149 STATE ST UNIT 6",
            "city": "MONTPELIER",
            "state": "VT",
            "postal_code": "056022965",
            "telephone_number": "802-522-8298"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDMONDSON",
        "first_name": "JACOB",
        "credential": "MA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-10-23",
        "last_updated": "2024-10-23",
        "certification_date": "2024-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "VT",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bonne Jane Dunham, L.M. , RN, IBCLC
• Jeffrey Dworkin, M.A.
• Jeremiah M Eckhaus, M.D.
• Edmondson Counseling Services LLC
• Edmondson Counseling Services LLC
• Kevin J. Egan, AS
• Diane Cecile Ehly, LCMHC
• Jeannette Ehrich-Meyer, DC
• Irvin Eisenberg, OT
• Casey Lynn Ellison, ND

• Mental Health Counselor in Montpelier, VT
• Providers in Montpelier, 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 Oct 23, 2024; 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.