Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Jackson Hole Mental Health LLC

Organization Clinical Social Worker · NPI 1053704726

Jackson Hole Mental Health LLC is a Clinical Social Worker in Jackson, Wyoming. Licensed in Wyoming. Registered with an NPI since 2015.

Licensed in
WY
In the registry since
2015
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

310 E Broadway Ave
Jackson, WY 83001-8636
Phone: (307) 654-7003
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 742 (WY)

Record details

NPI number1053704726
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Leah Black — Owner/Executive Director · (307) 654-7003
NPI enumeratedMarch 5, 2015
Last updated in NPPESApril 1, 2024
Certification dateApril 1, 2024
Mailing addressPo Box 13572, Jackson, WY 83002-3572

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