JIMMY D WIDENER (LPC) – Professional Counselor, NPI 1386684215

JIMMY D WIDENER (LPC) is a healthcare provider. based in Cedar bluff, Virginia. specializing in MENTAL HEALTH COUNSELOR. They hold the professional credentials LPC. They hold a License No. VA0701003500 (VA). The NPI Number for JIMMY D WIDENER (LPC) is 1386684215

Main info

Male
19 Years Of Experience
Accepts Medicare Assignment
Name
JIMMY D WIDENER (LPC)
NPI
1386684215
Phone
(276) 964-6702
Address
PO BOX 810
Enumeration Date
8 June 2006
Last Update Date
8 July 2007

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2769646702
Graduation Year
2007 (19 years ago)
PAC ID
2860929726
Group Practice PAC ID
2466355300
Professional Enrollment ID
I20241217002600
Address ID
VA246090810CE113XXRDXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

1,998 MENTAL HEALTH COUNSELOR in VA

Provider Addresses for JIMMY D WIDENER (LPC)

  • PO BOX 810

    CEDAR BLUFF, VA 24609

    Phone: (276) 964-6702

    Fax: (276) 964-5669

    Type: Mailing

  • RTE 19 - 460

    CEDAR BLUFF, VA 24609

    Phone: (276) 964-6702

    Fax: (276) 964-5669

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-12-17

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20241217002600IMental Health CounselorVATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 24609)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 2466355300View full group profile
NameSpecialtyState
Mental Health CounselorVA
-VA
Physician AssistantVA
-VA
-VA
Nurse PractitionerVA
P S Y C H I A T R YVA
P S Y C H I A T R YVA
Physician AssistantVA
Mental Health CounselorVA

Reviews

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Frequently asked questions

What unique ID ties claims to JIMMY D WIDENER (LPC)?
NPI 1386684215 is assigned to JIMMY D WIDENER (LPC) under the national enumeration system.
Is JIMMY D WIDENER (LPC)'s NPI currently valid?
The extract we use shows JIMMY D WIDENER (LPC) as active.
Can you summarize JIMMY D WIDENER (LPC)'s specialty in plain language?
Clinically, the directory lists JIMMY D WIDENER (LPC) with Professional Counselor. Clinical services aligned with this taxonomy classification.
What location metadata exists for JIMMY D WIDENER (LPC)?
The page summarizes Cedar Bluff, Virginia for JIMMY D WIDENER (LPC); expand the address list for detail.
How can I contact JIMMY D WIDENER (LPC)?
Phone or fax may appear on the official NPI record when supplied — verify before relying on them.

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