Individual provider Active NPI

Jasen J Livermore, LPC

  • Professional Counselor
  • Cody, WY
National Provider Identifier
1568053700
Registry record updated Sep 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LPC-2245 Issued in WY
Practice address
956 12TH St
Cody, WY 82414-3602
Phone
(307) 355-9266
NPI assigned
Jan 31, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X LPC-2245 WY Primary

Addresses

Primary practice location

956 12TH St
Cody, WY 82414-3602

Mailing address

2305 Greever St
Cody, WY 82414-9436
Phone (307) 355-9266

Other names 1

  • Jasen J Livermore Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WY
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

Enrollment IDStateProvider typePAC IDDetails
I20240404000889 WY Practitioner - Mental Health Counselor 8325486715 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

956 12TH St
Cody, WY 82414-3602
Phone (307) 355-9266

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LPC-2245WYMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Cloud Peak Counseling Center CurrentSince Dec 15, 2024 Accepting new patients
Zion Mountains Professional CurrentSince Oct 6, 2025 Accepting new patients
Chrysalis Treatment Center, Inc. PastSince Mar 1, 2022 Accepting new patients
Positive Progressions, LLC PastSince Mar 1, 2022 Accepting new patients

Locations

2538 Big Horn Ave
Cody, WY 82414
Phone (307) 587-2197

956 12th St
Cody, WY 82414
Phone (307) 355-9266

401 S 23rd St
Worland, WY 82401
Phone (307) 347-6165

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1612051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759190400000",
    "number": "1568053700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2305 GREEVER ST",
            "city": "CODY",
            "state": "WY",
            "postal_code": "824149436",
            "telephone_number": "307-355-9266",
            "fax_number": "307-568-2503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "956 12TH ST",
            "city": "CODY",
            "state": "WY",
            "postal_code": "824143602",
            "telephone_number": "307-355-9266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIVERMORE",
        "first_name": "JASEN",
        "middle_name": "J",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-01-31",
        "last_updated": "2025-09-30",
        "certification_date": "2025-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WY",
            "license": "LPC-2245",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JASEN",
            "last_name": "LIVERMORE",
            "middle_name": "J",
            "credential": "LPC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Cody, WY

Sources for this page

Verify at the official NPI Registry.