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JEANNE MARIE WICKHAM LPC, LAC
NPI 1265940696
Counselor - Mental Health in Colorado Springs, CO

Active since January 19, 2018Opted out of Medicare · through Mar 19, 2028
3225 TEMPLETON GAP RD STE 111, COLORADO SPRINGS, CO 80907(719) 351-9656 Get Directions Write a Review

NPPES record last updated: March 17, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Mar 17, 2025, Jan 19, 2018 (2 updates tracked since 2018).

About Jeanne Marie Wickham Lpc, Lac NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JEANNE MARIE WICKHAM LPC, LAC (NPI 1265940696) is an individual mental health provider in Colorado Springs, Colorado, licensed in Colorado (LPC.0017285) and active in the NPI registry since January 2018. She has opted out of Medicare through March 19, 2028.

NPPES Registry Identity

NPI1265940696
Entity TypeIndividualFemale
Primary Taxonomy101YM0800X
Provider Legal NameJEANNE MARIE WICKHAMCredential: LPC, LAC
Location Address3225 TEMPLETON GAP RD STE 111Colorado Springs, CO 80907-8729
Mailing Address3225 Templeton Gap Rd Ste 111Colorado Springs, CO 80907-8729 · (719) 351-9656
Phone(719) 351-9656
Sole ProprietorYes
Enumeration DateJanuary 19, 2018
Last NPPES UpdateMarch 17, 20252 updates tracked since enumeration
NPPES CertifiedMarch 12, 2025
✔ NPI 1265940696 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
License✔ Licensed in CO · LPC.0017285
Also ListedCounselor · Addiction (Substance Use Disorder)Taxonomy 101YA0400X · License ACD.0001464 (CO)
3225 TEMPLETON GAP RD STE 111, Colorado Springs, CO 80907
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Jeanne Marie Wickham Lpc, Lac has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from March 19, 2024 through March 19, 2028.

Opt-Out Effective DateMarch 19, 2024
Opt-Out In Effect ThroughMarch 19, 2028Opt-out affidavits renew automatically every two years unless cancelled

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jeanne Wickham's NPI number?

The NPI number for Jeanne Wickham is 1265940696. It was assigned to this individual provider in the NPPES registry on January 19, 2018.

Where is Jeanne Wickham located?

Jeanne Wickham practices at 3225 Templeton Gap Rd Ste 111, Colorado Springs, CO 80907. The listed phone number is (719) 351-9656.

What is Jeanne Wickham's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Is Jeanne Wickham enrolled in Medicare?

No. Jeanne Wickham has opted out of Medicare through March 19, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

When was this NPI record last updated?

The NPPES record for Jeanne Wickham was last updated on March 17, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.