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DR. JESSIE LEIGH KOLTZ PHD,NCC,NCSC,ACMHC
NPI 1881389013
Counselor - Mental Health in Logan, UT

Active since April 05, 2023PECOS Enrolled
2810 OLD MAIN HL, LOGAN, UT 84322(435) 797-1250 Get Directions Write a Review

NPPES record last updated: April 5, 2023. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Dr. Jessie Leigh Koltz Phd,ncc,ncsc,acmhc NPPES

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

DR. JESSIE LEIGH KOLTZ PHD,NCC,NCSC,ACMHC (NPI 1881389013) is an individual mental health provider in Logan, Utah, licensed in Utah (12557230-6009) and active in the NPI registry since April 2023. She is enrolled in Medicare PECOS and is a graduate of University Of Nevada School Of Medicine (2021).

NPPES Registry Identity

NPI1881389013
Entity TypeIndividualFemale
Primary Taxonomy101YM0800X
Provider Legal NameDR. JESSIE LEIGH KOLTZCredential: PHD,NCC,NCSC,ACMHC
Location Address2810 OLD MAIN HLLogan, UT 84322-2810
Mailing Address2810 Old Main HlLogan, UT 84322-2810 · (435) 797-1250
Phone(435) 797-1250
Sole ProprietorNo
Medical School CMSUniversity Of Nevada School Of MedicineGraduated 2021
Enumeration DateApril 5, 2023
NPPES CertifiedApril 5, 2023
✔ NPI 1881389013 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
License✔ Licensed in UT · 12557230-6009
2810 OLD MAIN HL, Logan, UT 84322
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, Ambetter Health, Blue Cross and Blue Shield of Texas and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Jessie Leigh Koltz Phd,ncc,ncsc,acmhc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID8224593371
PECOS Enrollment IDI20260720003421
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Jessie Koltz reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Ideal Mental Health LLC
440 mi
Clinical
5335 RENO CORPORATE DR
Reno, NV 89511
  • Reassigned Medicare billing, Nevada enrollment
  • 9 clinicians in this Medicare group
NPI 1902660277 (775) 622-7272

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 7

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

GRETCHEN GIMPEL PEACOCK
Psychologist
2810 OLD MAIN HL, DEPARTMENT OF PSYCHOLOGY
LOGAN, UT 84322
Cache County (435) 797-0721
DR. MELANIE MARIE DOMENECH RODRIGUEZ PH.D.
Psychologist
2810 OLD MAIN HL, DPT. OF PSYCHOLOGY
LOGAN, UT 84322
Cache County (435) 797-3059
UTAH STATE UNIVERSITY
Psychologist
2810 OLD MAIN HL
LOGAN, UT 84322
Cache County (435) 797-3401
SUSAN CROWLEY P.H.D.
Psychologist (Clinical)
2810 OLD MAIN HL
LOGAN, UT 84322
Cache County (435) 797-3401
MICHAEL SCOTT DEBERARD PHD, M.S., B.A.
Psychologist (Clinical)
2810 OLD MAIN HL
LOGAN, UT 84322
Cache County (435) 797-3401
UTAH STATE UNIVERSITY
Psychologist (Clinical)
2810 OLD MAIN HL
LOGAN, UT 84322
Cache County (435) 797-3401
DR. REBECCA KATE BLAIS PHD
Psychologist (Clinical)
2810 OLD MAIN HL
LOGAN, UT 84322
Cache County (435) 850-7437

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 Jessie Koltz's NPI number?

The NPI number for Jessie Koltz is 1881389013. It was assigned to this individual provider in the NPPES registry on April 5, 2023.

Where is Jessie Koltz located?

Jessie Koltz practices at 2810 Old Main Hl, Logan, UT 84322. The listed phone number is (435) 797-1250.

What is Jessie Koltz's specialty?

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

Is Jessie Koltz enrolled in Medicare?

Yes. Jessie Koltz is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Jessie Koltz's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jessie Koltz reassigns Medicare benefits to Ideal Mental Health LLC (Reno, NV). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Jessie Koltz's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Jessie Koltz accept?

Health plans from Ambetter Health, Ambetter from Arizona Complete Health, Blue Cross and Blue Shield of Texas, BridgeSpan Health Company and Molina Healthcare and 2 other insurers list Jessie Koltz as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Jessie Koltz was last updated on April 5, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years 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.