NORTHERN WYOMING MENTAL HEALTH CENTER, INC. (NPI# 1558415927) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558415927 |
| Entity Type | Organization |
| Organization Name | NORTHERN WYOMING MENTAL HEALTH CENTER, INC. |
| Practice Address |
420 1-2 Main St Sundance WY 82729-0646 |
| Mailing Address |
Po Box 646 Sundance WY 82729-0646 |
| Practice Telephone | 3072833636 |
| Practice Fax Number | 3072832898 |
| Mailing Telephone | 3072833636 |
| Mailing Fax Number | 3072832898 |
| Enumeration Date | 2007-01-23 |
| Last Update Date | 2020-10-25 |
| Authorized Official Name | PAUL E. DEMPLE (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Telephone | 3076728958 |
| Authorized Official Credential | MA, LPC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
WY | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WY | 106076706 | 05 | |
| WY | BCBS | 01175001 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124302005 | Northern Wyoming Mental Health Center, Inc. | Clinic/Center | 420 1/2 Main St, Sundance, WY 82729 | 2011-10-10 |
| 1386798239 | Northern Wyoming Mental Health Center, Inc. | Clinic/Center | 521 W Lott St, Buffalo, WY 82834-1642 | 2007-01-22 |
| 1013292473 | Northern Wyoming Mental Health Center, Inc. | Clinic/Center | 1221 W 5th St, Sheridan, WY 82801-2701 | 2011-10-18 |
| 1548545106 | Northern Wyoming Mental Health Center, Inc. | Clinic/Center | 521 W Lott St, Buffalo, WY 82834-1642 | 2011-10-14 |
| 1093090656 | Northern Wyoming Mental Health Center, Inc. | Clinic/Center | 1701 W 5th St, Suite C, Sheridan, WY 82801-2748 | 2011-10-14 |
| 1588948673 | Northern Wyoming Mental Health Center, Inc. | Clinic/Center | 420 Deanne Ave, Newcastle, WY 82701-2936 | 2011-10-06 |
| 1619021912 | Northern Wyoming Mental Health Center, Inc. | Clinic/Center | 1221 W 5th St, Sheridan, WY 82801-2701 | 2007-01-23 |
| 1952455834 | Northern Wyoming Mental Health Center, Inc. | Clinic/Center | 1701 W 5th St, Suite C, Sheridan, WY 82801-2748 | 2007-01-22 |
| Street Address |
420 1-2 MAIN ST |
| City | SUNDANCE |
| State | WY |
| Zip Code | 82729-0646 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730706128 | Shenae Kayleen Lacroix | Physical Medicine & Rehabilitation | 2719 Wy-585, Sundance, WY 82729 | 2020-07-01 |
| 1245898642 | Katherine Suzanne Wilkins | Physical Therapist | 2719 State Hwy 585, Sundance, WY 82729 | 2019-05-31 |
| 1023445459 | Micki Dahne Lyons | Nurse Practitioner | 713 W. Oak Street, Sundance, WY 82729 | 2013-09-30 |
| 1124302005 | Northern Wyoming Mental Health Center, Inc. | Clinic/Center | 420 1/2 Main St, Sundance, WY 82729 | 2011-10-10 |
| 1033497425 | Lacey Waddell | Dietitian, Registered | 713 W Oak Street, Sundance, WY 82729 | 2011-08-02 |
| 1952433302 | Rita Larae Vannorman | Social Worker | 420 1/2 Main St., Sundance, WY 82729 | 2007-03-12 |
| 1720138910 | Cheryl Ann Wales | Counselor | 2101 Hwy 14, Sundance, WY 82729 | 2007-01-11 |
| 1902862295 | Veronica L Kramer | Physical Therapist | 226 South Hwy 585, Sundance, WY 82729 | 2006-04-25 |
| 1629476270 | Vilas Pharmacy | Pharmacy | 224 E Main Street, Sundance, WY 82729 | 2014-12-15 |
| 1366868150 | Brianne Wooldridge | Counselor | 405 Main St, Sundance, WY 82729 | 2014-03-17 |
| Find all providers in zip 82729 | ||||
| Taxonomy Code | 261QM0801X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Mental Health (Including Community Mental Health Center) |
| Definition to come... |
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| 1225693872 | Himes Counseling LLC | Clinic/Center | 113 S Gillette Ave Ste 215, Gillette, WY 82716-3741 | 2019-05-08 |
| 1528538931 | Whole Life Counseling LLC | Clinic/Center | 1800 W 4j Rd, Gillette, WY 82718-9109 | 2018-11-28 |
| 1295211787 | Nicole Rue, Psy.d., LLC | Clinic/Center | 1115 Maple Way Ste D, Jackson, WY 83001-8567 | 2018-07-17 |
| 1619465838 | Elevate Counseling | Clinic/Center | 116 5th St Ste 8, Rawlins, WY 82301-5632 | 2018-04-23 |
| 1649795907 | Cowboy Psychological Services PC | Clinic/Center | 1123 Big Horn Ave Ste A, Worland, WY 82401-2814 | 2017-08-08 |
| 1346792298 | Elisabeth Krause | Clinic/Center | 65 N, Granier Ave, Atlantic City, WY 82520 | 2016-10-26 |
| 1245605344 | Magellan Healthcare | Clinic/Center | 8035 W Chalk Creek Rd, Casper, WY 82604-1744 | 2015-12-01 |
| 1700258514 | Peaceful Minds, LLC | Clinic/Center | 1300 E A St Ste 101, Casper, WY 82601-2211 | 2015-10-20 |
| 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.