Jennifer Pederson

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

PPC-1614 Issued in WY

Practice address

420 Deanne Ave Ste 2
Newcastle, WY 82701-2936

Phone

(307) 746-8157

NPI assigned

Jul 12, 2024

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1720742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780099200000",
    "number": "1730926023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 DEANNE AVE STE 2",
            "city": "NEWCASTLE",
            "state": "WY",
            "postal_code": "827012936",
            "telephone_number": "307-746-8157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 DEANNE AVE STE 2",
            "city": "NEWCASTLE",
            "state": "WY",
            "postal_code": "827012936",
            "telephone_number": "307-746-8157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEDERSON",
        "first_name": "JENNIFER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-07-12",
        "last_updated": "2026-05-30",
        "certification_date": "2026-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Massage Therapist",
            "state": "SD",
            "license": "MT11968",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "WY",
            "license": "PPC-1614",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lisa Joy Ohnstad, PHARMD
• John Olenyik
• On Target Clinical Case Management Services
• Diane Kay Ottema Christensen, RN
• Tarah D Parsons, RPH
• Patricia Pena
• Mary Alice Petersen, MA, CCC-SLP
• Hope Phelon, LCSW. LAT
• Rangeland Inpatient Services LLC
• Mike Ratigan, LCSW

• Mental Health Counselor in Newcastle, WY
• Providers in Newcastle, WY by specialty
• Mental Health Counselor in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.