Jackson Hole Mental Health Llc - Medicare Mental Health Clinic in Jackson, WY

Jackson Hole Mental Health Llc is a medicare enrolled mental health clinic (Social Worker - Clinical) in Jackson, Wyoming. The current practice location for Jackson Hole Mental Health Llc is 310 E Broadway Ave, Jackson, Wyoming. For appointments, you can reach them via phone at (307) 654-7003. The mailing address for Jackson Hole Mental Health Llc is Po Box 13572, Jackson, Wyoming and phone number is (307) 654-7003.

Jackson Hole Mental Health Llc is licensed to practice in Wyoming (license number 742). The clinic also participates in the medicare program and its NPI number is 1053704726. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (307) 654-7003.

Contact Information

Jackson Hole Mental Health Llc
310 E Broadway Ave
Jackson
WY 83001-8636
(307) 654-7003
Not Available

Mental Health Clinic Profile

Full NameJackson Hole Mental Health Llc
SpecialitySocial Worker
Location310 E Broadway Ave, Jackson, Wyoming
Authorized Official Name and PositionLeah C Black (OWNER/EXECUTIVE DIRECTOR)
Authorized Official Contact3076547003
Accepts Medicare InsuranceYes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Jackson Hole Mental Health Llc
Po Box 13572
Jackson
WY 83002-3572

Ph: (307) 654-7003
Jackson Hole Mental Health Llc
310 E Broadway Ave
Jackson
WY 83001-8636

Ph: (307) 654-7003

NPI Details:

NPI Number1053704726
Provider Enumeration Date03/05/2015
Last Update Date04/01/2024
Certification Date04/01/2024

Medicare PECOS Information:

Medicare PECOS PAC ID5496076002
Medicare Enrollment IDO20150608002987

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Medical Identifiers

Medical identifiers for Jackson Hole Mental Health Llc such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1053704726NPI-NPPES
130859900MedicaidWY

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
1041C0700XSocial Worker - Clinical 742 (Wyoming)Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Jackson Hole Mental Health Llc acts as a billing entity for following providers:
Provider NameLeah Charlene Black
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1003107731
PECOS PAC ID: 6305167917
Enrollment ID: I20150617002976

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National data demonstrate that 1 in 6 U.S. adolescents has high-frequency hearing loss. A new report from the University of Michigan C.S. Mott Children's Hospital National Poll on Children's Health shows that many parents don't think their teens are at risk.

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Social Worker in Jackson, WY

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