Active NPI
Timothy Peter Jurkowski, MA, LPC
- Professional Counselor
- Cheyenne, WY
National Provider Identifier
1871801290
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- LPC-1236
- Practice address
- 507 E 18TH St
Cheyenne, WY 82001-4617 - Phone
- (307) 365-0285
- Fax
- (307) 635-3965
- NPI assigned
- Sep 20, 2010
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | LPC-1236 | WY | Primary |
Addresses
Primary practice location
507 E 18TH St
Cheyenne, WY 82001-4617
Mailing address
520 E 18TH St
Cheyenne, WY 82001-4618
Phone (307) 638-4625
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LPC-1236 | WY | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1284940800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1404950400000",
"number": "1871801290",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "520 E 18TH ST",
"city": "CHEYENNE",
"state": "WY",
"postal_code": "820014618",
"telephone_number": "307-638-4625",
"fax_number": "307-635-3965"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "507 E 18TH ST",
"city": "CHEYENNE",
"state": "WY",
"postal_code": "820014617",
"telephone_number": "307-365-0285",
"fax_number": "307-635-3965"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JURKOWSKI",
"first_name": "TIMOTHY",
"middle_name": "PETER",
"credential": "MA, LPC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-09-20",
"last_updated": "2014-07-10",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "WY",
"license": "LPC-1236",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cheyenne, WY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.