Individual provider Active NPI

Katelyn Ann Webb, LPC

  • Professional Counselor
  • Jackson, WY
National Provider Identifier
1821686528
Registry record updated Dec 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LPC-1786 Issued in WY
Practice address
625 E Broadway Ave
Jackson, WY 83001-8642
Phone
(307) 739-7482
Fax
(307) 739-7229
NPI assigned
Jan 7, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 29, 2023

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-1786 WY Primary

Addresses

Primary practice location

625 E Broadway Ave
Jackson, WY 83001-8642

Mailing address

PO Box 428
Jackson, WY 83001-0428
Phone (307) 739-7482

Other practice location 1

1310 Buckskin Loop
Victor, ID 83455-1327
Phone (512) 639-4454

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WY, ID2 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

Enrollment IDStateProvider typePAC IDDetails
I20240207000233 WY Practitioner - Mental Health Counselor 3971946971 Practice locations: Jackson, WY
I20240328002445 ID Practitioner - Mental Health Counselor 3971946971 Practice locations: Driggs, ID; Victor, ID

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2016
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

125 S King St
Jackson, WY 83001-8124
Phone (307) 264-0840

1310 Buckskin Loop
Victor, ID 83455-1327
Phone (307) 264-0840

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LPC-1786WYMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Pine Creek Counseling CurrentSince Jan 30, 2024 Accepting new patients

Locations

85 S Main St
Ste 4
Driggs, ID 83422
Phone (307) 264-0840

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1609977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703808000000",
    "number": "1821686528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 428",
            "city": "JACKSON",
            "state": "WY",
            "postal_code": "830010428",
            "telephone_number": "307-739-7482",
            "fax_number": "307-739-7229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 E BROADWAY AVE",
            "city": "JACKSON",
            "state": "WY",
            "postal_code": "830018642",
            "telephone_number": "307-739-7482",
            "fax_number": "307-739-7229"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1310 Buckskin Loop",
            "address_purpose": "LOCATION",
            "city": "Victor",
            "state": "ID",
            "postal_code": "834551327",
            "country_code": "US",
            "telephone_number": "512-639-4454",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WEBB",
        "first_name": "KATELYN",
        "middle_name": "ANN",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-01-07",
        "last_updated": "2023-12-29",
        "certification_date": "2023-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WY",
            "license": "LPC-1786",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, WY

Sources for this page

Verify at the official NPI Registry.