Individual provider Active NPI

Jayme R. Ackerman, MS, LPC

  • Counselor
  • Sheridan, WY
National Provider Identifier
1639697535
Registry record updated Jul 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
LPC-2112 Issued in WY
Practice address
3322 Strahan Pkwy
Sheridan, WY 82801-9162
Phone
(307) 672-2044
NPI assigned
Aug 31, 2017
Last updated
Jul 24, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X LPC-2112 WY Primary
Case Manager/Care Coordinator 171M00000X NU

Addresses

Primary practice location

3322 Strahan Pkwy
Sheridan, WY 82801-9162

Mailing address

3322 Strahan Pkwy
Sheridan, WY 82801-9162
Phone (307) 672-2044

Other names 1

  • Jayme R Wallace Former 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
I20240228003762 WY Practitioner - Mental Health Counselor 6901241017 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
LPC-2112WYMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
Volunteers of America Northern Rockies CurrentSince Jan 28, 2026 Accepting new patients
Volunteers of America Northern Rockies Past Accepting new patients

Locations

510 W 29th St
Cheyenne, WY 82001
Phone (307) 426-4728

3322 Strahan Pkwy
Sheridan, WY 82801
Phone (307) 638-8182

Organizations & group practices 3

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": "1504137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690156800000",
    "number": "1639697535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3322 STRAHAN PKWY",
            "city": "SHERIDAN",
            "state": "WY",
            "postal_code": "828019162",
            "telephone_number": "307-672-2044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3322 STRAHAN PKWY",
            "city": "SHERIDAN",
            "state": "WY",
            "postal_code": "828019162",
            "telephone_number": "307-672-2044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ACKERMAN",
        "first_name": "JAYME",
        "middle_name": "R.",
        "credential": "MS, LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-31",
        "last_updated": "2023-07-24",
        "certification_date": "2023-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "WY",
            "license": "LPC-2112",
            "primary": true
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JAYME",
            "last_name": "WALLACE",
            "middle_name": "R",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Sheridan, WY

Sources for this page

Verify at the official NPI Registry.