MARY JO JEFFRES PHD, LLC (NPI# 1962563361) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962563361 |
| Entity Type | Organization |
| Organization Name | MARY JO JEFFRES PHD, LLC |
| Practice Address |
103 N 5th St E Riverton WY 82501-4402 |
| Practice Telephone | (307) 463-0890 |
| Practice Fax Number | 3074630891 |
| Mailing Telephone | (307) 463-0890 |
| Mailing Fax Number | 3074630891 |
| Enumeration Date | 2006-12-12 |
| Last Update Date | 2018-03-17 |
| Authorized Official Name | MARY JO JEFFRES (OWNER) |
| Authorized Official Telephone | 3074630890 |
| Authorized Official Credential | PHD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
421 | WY | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WY | 121869700 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 500 E. Fremont Avenue, Riverton, WY 825014409 | 3078517170 | 8669565856 |
| Street Address |
103 N 5TH ST E |
| City | RIVERTON |
| State | WY |
| Zip Code | 82501-4402 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629013784 | Mary Jo Jeffres | Psychologist | 103 N 5th St E, Riverton, WY 82501-4402 | 2006-06-20 |
| 1770607426 | Susan Dianne Johnson | Social Worker | 103 N 5th St E, Riverton, WY 82501-4402 | 2007-03-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366914889 | Community Health Center of Central Wyoming Inc | Clinic/Center | 704 Fremont Ave, Riverton, WY 82501 | 2018-12-21 |
| 1699292391 | Wind River Cares Riverton | Clinic/Center | 511 North 12 Street East, Riverton, WY 82501 | 2017-08-24 |
| 1801242268 | Jessika Ruth Waldron | Case Manager/Care Coordinator | 1519 1/2 E Pershing, Riverton, WY 82501 | 2016-05-04 |
| 1467815498 | Orren P Janis Sr. | Community Health Worker | 10369 Highway 789, 10369 Hwy 789, Riverton, WY 82501 | 2016-03-29 |
| 1194186320 | Amanda R Vroman | Counselor | 10269 Hwy 789, Riverton, WY 82501 | 2016-03-16 |
| 1770944902 | William Nolan Sage | Counselor | 10269 Hwy. 789, Riverton, WY 82501 | 2016-03-16 |
| 1962806331 | Moss Dentistry | Dentist | 203 E Main Street, Suite 205, Riverton, WY 82501 | 2014-10-14 |
| 1215339957 | Jordan Hays | Registered Nurse | 11855 Us Highway 26, Riverton, WY 82501 | 2014-09-25 |
| 1538584750 | Michaela R Sisneros | Nursing Care | 2890 Cooper Rd, Riverton, WY 82501 | 2014-02-25 |
| 1487089843 | Olivia P Washington | Registered Nurse | 43 Goes In Lodge Road, Riverton, WY 82501 | 2013-09-04 |
| Find all providers in zip 82501 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164726766 | Marc Douglas Mclaughlin | Psychologist | 205 S Broadway Ave, Riverton, WY 82501-4349 | 2010-12-22 |
| 1033298500 | Charles W Rodgers Phd PC | Psychologist | 607 East Washington, Riverton, WY 82501 | 2006-11-03 |
| 1629013784 | Mary Jo Jeffres | Psychologist | 103 N 5th St E, Riverton, WY 82501-4402 | 2006-06-20 |
| 1417509464 | Stephanie Babbitt | Psychologist | 3723 W 12600 S, Riverton, UT 84065-7295 | 2019-07-10 |
| 1265683155 | Charles W Rodgers | Psychologist | 607 East Washington, Riverton, WY 82501 | 2008-10-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639700750 | Unaccompanied Student Initiative | Psychologist | 910 W Fox Farm Rd, Cheyenne, WY 82007-2674 | 2020-01-28 |
| 1730731696 | Shaina Smith | Psychologist | 1401 Airport Pkwy Ste 240, Cheyenne, WY 82001-1542 | 2019-07-11 |
| 1538623020 | Caitilin Barrett | Psychologist | 1215 Jessi Dr, Cheyenne, WY 82009-1880 | 2019-01-29 |
| 1043756174 | Maribeth L. Hesser | Psychologist | 6675 N Upper Cascade Dr, Jackson, WY 83001-9390 | 2017-01-12 |
| 1811346943 | Bryan David Peltier | Psychologist | 125 Fox Hills Dr, Green River, WY 82935-7100 | 2016-06-09 |
| 1558760207 | Victoria Menghetti Smith | Psychologist | 3510 N Lake Creek Dr, Wilson, WY 83014-9695 | 2014-08-19 |
| 1508283946 | Christine Mckibbin | Psychologist | 2524 Dover Dr, Laramie, WY 82072-2990 | 2014-03-24 |
| 1609140706 | Casper Family Connections | Psychologist | 500 S Wolcott St Ste 102, Casper, WY 82601-2882 | 2012-03-07 |
| 1417246869 | John C Dolores | Psychologist | 5303 Mountain Rd, Apt C, Cheyenne, WY 82009-5049 | 2011-04-06 |
| 1295060614 | Todd M Wahl Psyd LLC | Psychologist | 2315 Dunn Ave # 6, Cheyenne, WY 82001-3214 | 2009-10-03 |
| Find all providers with the same taxonomy | ||||
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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.