TETON WELLNESS AFFILIATES (NPI# 1407480890) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407480890 |
| Entity Type | Organization |
| Organization Name | TETON WELLNESS AFFILIATES |
| Practice Address |
125 E Pearl Ave Ste B005 Jackson WY 83001-8599 |
| Mailing Address |
Po Box 2019 Jackson WY 83001-2019 |
| Practice Telephone | 3076995025 |
| Mailing Telephone | 3076995025 |
| Enumeration Date | 2020-02-25 |
| Last Update Date | 2020-06-23 |
| Authorized Official Name | MS. LORRAINE THOMPSON (OWNER) |
| Authorized Official Telephone | 3076995025 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
Ambulatory Health Care Facilities |
| Street Address |
125 E PEARL AVE STE B005 |
| City | JACKSON |
| State | WY |
| Zip Code | 83001-8599 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003122797 | Lorraine Thompson | Counselor | 125 E Pearl Ave Ste B005, Jackson, WY 83001-8599 | 2010-08-19 |
| 1013516541 | Tracy Hiatt | Counselor | 125 E Pearl Ave Ste B005, Jackson, WY 83001-8599 | 2020-10-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861006108 | Anne Kathleen Milburn | Physical Therapist | 3620 S Park Drive, Jackson, WY 83001 | 2020-09-03 |
| 1568009637 | Katherine Pringle Ford | Case Manager/Care Coordinator | 2065 E. Limber Pine Road, Jackson, WY 83001 | 2019-12-07 |
| 1043878408 | Cossette Burnham | Physical Therapist | Four Pines Physical Therapy, 1090 S Hwy 89, Jackson, WY 83001 | 2019-05-31 |
| 1982169371 | Cynthia Buck Huyffer | Social Worker | 755a Cache Creek Drive, Jackson, WY 83001 | 2019-02-10 |
| 1093281594 | Lara Cilo | Speech-Language Pathologist | 1300 W. Valley Springs Road, Jackson, WY 83001 | 2018-10-23 |
| 1740776202 | Teton Oral and Maxillofacial Surgery | Dentist | 1160 Alpine Ln Ste 1d, Jackson, WY 83001 | 2018-07-09 |
| 1437642055 | Anna Yanchek | Physical Therapist | 1090 Us- 89, Jackson Hole, WY 83001 | 2018-06-08 |
| 1891200762 | Tyler Ross Wright | Chiropractor | 1325 Us-89, Suite 108, Jackson, WY 83001 | 2017-12-13 |
| 1073027280 | Root To Rise Counseling and Consulting, Pllc | Social Worker | 2033 Dandelion Court, Jackson, WY 83001 | 2017-11-27 |
| 1962923912 | Piper Worthington | Social Worker | 1910 High School Rd, Jackson, WY 83001 | 2017-06-29 |
| Find all providers in zip 83001 | ||||
| Taxonomy Code | 261QM0801X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Mental Health (Including Community Mental Health Center) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871103127 | Lupine Mental Health and Integrative Psychiatry LLC | Clinic/Center | 125 E Pearl Ave Ste 207, Jackson, WY 83001-8599 | 2020-08-02 |
| 1750908182 | Horizon Connections | Clinic/Center | 1818 Crane Ridge Dr Ste 101, Jackson, MS 39216-4912 | 2020-07-01 |
| 1295211787 | Nicole Rue, Psy.d., LLC | Clinic/Center | 1115 Maple Way Ste D, Jackson, WY 83001-8567 | 2018-07-17 |
| 1881102408 | Ava Family Services, LLC | Clinic/Center | 1910 Lakeland Dr Ste C, Jackson, MS 39216 | 2018-01-17 |
| 1033628466 | Bhg Lii, LLC | Clinic/Center | 794 Mcdonough Rd Ste 104, Jackson, GA 30233-1572 | 2017-09-28 |
| 1356732317 | Golden Gold Child Learning Center | Clinic/Center | 1155 Jackson Blvd, Jackson, MS 39204-2733 | 2015-02-12 |
| 1194964049 | Beacon Behavioral Health-jackson | Clinic/Center | 5360 I 55 N, Jackson, MS 39211-4026 | 2009-02-17 |
| 1134366867 | Mississippi State Hospital | Clinic/Center | 350 Capers Ave, Jackson, MS 39203-2131 | 2009-01-16 |
| 1780852194 | Mcwillie Counseling & Diagnostic Services | Clinic/Center | 5202 Keele St Ste 1, Jackson, MS 39206-4355 | 2008-02-19 |
| 1689628190 | Catholic Charities of Jackson, Lenawee and Hillsdale Counties | Clinic/Center | 1522 Joy Ave, Jackson, MI 49203-1933 | 2006-05-20 |
| Find all providers in JACKSON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.