NPIMap

Organization Active NPI

Mental Health & Recovery Services of Jackson Hole

Doing business as Curran-Seeley Foundation

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Jackson, WY
National Provider Identifier
1578635462
Registry record updated Jul 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
MENTAL HEALTH & RECOVERY SERVICES OF JACKSON HOLE
Doing business as
Curran-Seeley Foundation
Jackson Hole Community Counseling Center
Practice address
640 E Broadway Ave
Jackson, WY 83001
Phone
(307) 733-2046
Fax
(307) 733-6289
NPI assigned
Nov 15, 2006
Last updated
Jul 19, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2023

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

Authorized official

Name
Deidre AshleyNPI 1992038079
Title
Executive Director
Phone
(307) 733-2046

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Developmentally Disabled Services Day Training Agency 251C00000X NU
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X NU Primary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X NU

Addresses

Primary practice location

640 E Broadway Ave
Jackson, WY 83001

Mailing address

PO Box 1868
640 East Broadway
Jackson, WY 83001-1868
Phone (307) 733-2046

Other practice location 1

610 W Broadway Ave Ste L-1
Jackson, WY 83001-8213
Phone (307) 733-3908

Other identifiers 4

IdentifierTypeStateIssuer
106872503MedicaidWA
00708001OtherWYBLUSE CROSS BLUE SHIELD
106872504MedicaidWY
106872500MedicaidWY

Other names 2

  • Curran-Seeley Foundation Doing business as
  • Jackson Hole Community Counseling Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040607000292 WY Part B Supplier - Clinic/Group Practice 0840272472 Receives reassigned benefits from 14 practitioners
Practice locations: Jackson, WY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 51

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.

View all 51

NPI Registry JSON

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1689724800000",
    "number": "1578635462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1868",
            "address_2": "640 EAST BROADWAY",
            "city": "JACKSON",
            "state": "WY",
            "postal_code": "830011868",
            "telephone_number": "307-733-2046",
            "fax_number": "307-733-6289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 E BROADWAY AVE",
            "city": "JACKSON",
            "state": "WY",
            "postal_code": "83001",
            "telephone_number": "307-733-2046",
            "fax_number": "307-733-6289"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "610 W Broadway Ave Ste L-1",
            "address_purpose": "LOCATION",
            "city": "Jackson",
            "state": "WY",
            "postal_code": "830018213",
            "country_code": "US",
            "telephone_number": "307-733-3908",
            "fax_number": "307-734-0017",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MENTAL HEALTH & RECOVERY SERVICES OF JACKSON HOLE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-15",
        "last_updated": "2023-07-19",
        "certification_date": "2023-07-19",
        "status": "A",
        "authorized_official_last_name": "ASHLEY",
        "authorized_official_first_name": "DEIDRE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "307-733-2046"
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "106872503",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUSE CROSS BLUE SHIELD",
            "identifier": "00708001",
            "state": "WY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "106872504",
            "state": "WY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "106872500",
            "state": "WY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Curran-Seeley Foundation",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Jackson Hole Community Counseling Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jackson, WY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2023; 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.