Jackson Hole Mental Health LLC
NPI 1053704726 · Clinical Social Worker · Jackson, WY
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Jackson Hole Mental Health LLC is a Clinical Social Worker organization in Jackson, WY (NPI 1053704726).
Provider details
- NPI number
- 1053704726
- Entity type
- Organization
- Primary specialty
- Clinical Social WorkerBehavioral Health & Social Service Providers
- Organization subpart
- No
- Authorized official
- Leah Black, Owner/Executive Director(307) 654-7003
- License
- 742 (WY)
Specialties & taxonomies
Behavioral Health & Social Service Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
11 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2015-03-05
- Last updated
- 2024-04-01
- Certified
- 2024-04-01
Frequently asked questions
- What is Jackson Hole Mental Health LLC's NPI number?
- Jackson Hole Mental Health LLC's National Provider Identifier (NPI) is 1053704726, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Jackson Hole Mental Health LLC?
- Jackson Hole Mental Health LLC is classified in the NPPES registry as Clinical Social Worker (Behavioral Health & Social Service Providers).
- Where is Jackson Hole Mental Health LLC located?
- Jackson Hole Mental Health LLC's practice location on file with NPPES is 310 E Broadway Ave, Jackson, WY 83001-8636.
- What is Jackson Hole Mental Health LLC's phone number?
- The practice phone number listed in the NPPES registry for Jackson Hole Mental Health LLC is (307) 654-7003.
- Does Jackson Hole Mental Health LLC accept Medicare?
- Jackson Hole Mental Health LLC is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Jackson Hole Mental Health LLC?
- The authorized official listed on Jackson Hole Mental Health LLC's NPPES record is Leah Black, Owner/Executive Director. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Jackson Hole Mental Health LLC's NPI active?
- Yes — Jackson Hole Mental Health LLC's NPI (1053704726) is active in the NPPES registry as of the last update on 2024-04-01.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.