CAROLJEAN BONGO PSYD LLC (NPI# 1821297102) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821297102 |
| Entity Type | Organization |
| Organization Name | CAROLJEAN BONGO PSYD LLC |
| Practice Address |
2909 Bent Ave Cheyenne WY 82001-2742 |
| Mailing Address |
Po Box 21270 Cheyenne WY 82003-7025 |
| Practice Telephone | 3077601871 |
| Practice Fax Number | 8666211893 |
| Mailing Telephone | (307) 760-1871 |
| Mailing Fax Number | 8666211893 |
| Enumeration Date | 2007-07-16 |
| Last Update Date | 2017-09-27 |
| Authorized Official Name | DR. CAROLJEAN BONGO (CLINICAL PSYCHOLOGIST) |
| Authorized Official Telephone | 3077601871 |
| Authorized Official Credential | PSYD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
432 | WY | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WY | 124350100 | 05 |
| Street Address |
2909 BENT AVE |
| City | CHEYENNE |
| State | WY |
| Zip Code | 82001-2742 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972587319 | Jill C Favata | Counselor | 2909 Bent Ave, The Healing Center, Cheyenne, WY 82001-2742 | 2005-11-30 |
| 1356647291 | Randall Beaubouef | Social Worker | 2909 Bent Ave, Cheyenne, WY 82001-2742 | 2011-02-09 |
| 1871721779 | Jamie M. Rogers | Social Worker | 2909 Bent Ave, Cheyenne, WY 82001-2742 | 2009-06-30 |
| 1104063338 | Charles David Skinner | Counselor | 2909 Bent Ave, Cheyenne, WY 82001-2742 | 2009-01-09 |
| 1659560225 | Anna M Russell Lcsw PC | Social Worker | 2909 Bent Ave, Cheyenne, WY 82001-2742 | 2007-10-19 |
| 1326177841 | Anna M Russell | Social Worker | 2909 Bent Ave, Cheyenne, WY 82001 | 2007-03-02 |
| 1922159805 | Stephanie Anne James | Social Worker | 2909 Bent Ave, Cheyenne, WY 82001 | 2007-01-16 |
| 1134220189 | Caroljean Bongo | Psychologist | 2909 Bent Ave, Cheyenne, WY 82001-2742 | 2006-09-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194382150 | Brain Advancement Center, LLC | Counselor | 2005 Warren Ave., Cheyenne, WY 82001 | 2019-05-24 |
| 1255897385 | Humble Horizon Home Health LLC | Case Management | 6066 Wilderness Trl, Cheyenne, WY 82001 | 2019-02-13 |
| 1396214722 | Megan Kraushaar | Behavior Technician | 3120 Old Faithful Rd, Cheyenne, WY 82001 | 2018-11-14 |
| 1255815536 | Michelle Mae Mccoy | Social Worker | 2360 E Perishing Blvd, Cheyenne, WY 82001 | 2018-09-21 |
| 1750869616 | Finding Peace Counseling, LLC | Counselor | 1603 Capitol Ave Ste 510b, Cheyenne, WY 82001 | 2018-08-02 |
| 1457855595 | Better Life Counseling LLC | Counselor | 2909 Bent Ave Ste 5, Cheyenne, WY 82001 | 2018-03-22 |
| 1942729066 | Brittany Heinzman | Community Health Worker | 2000 Westland Road Suite C, Cheyenne, WY 82001 | 2017-09-11 |
| 1144768086 | Cheyenne Regional Home Home Care Services | Case Management | 214 E 23rd Street, Cheyenne, WY 82001 | 2017-02-10 |
| 1104360726 | Jennifer Pannebaker | Behavioral Analyst | 813 Randall Ave, Cheyenne, WY 82001 | 2016-12-16 |
| 1053854703 | Raven Coward Long | Social Worker | 821 East Pershing Blvd, Cheyenne, WY 82001 | 2016-11-29 |
| Find all providers in zip 82001 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639700750 | Unaccompanied Student Initiative | Psychologist | 910 W Fox Farm Rd, Cheyenne, WY 82007-2674 | 2020-01-28 |
| 1730731696 | Shaina Smith | Psychologist | 1401 Airport Pkwy Ste 240, Cheyenne, WY 82001-1542 | 2019-07-11 |
| 1538623020 | Caitilin Barrett | Psychologist | 1215 Jessi Dr, Cheyenne, WY 82009-1880 | 2019-01-29 |
| 1417246869 | John C Dolores | Psychologist | 5303 Mountain Rd, Apt C, Cheyenne, WY 82009-5049 | 2011-04-06 |
| 1295060614 | Todd M Wahl Psyd LLC | Psychologist | 2315 Dunn Ave # 6, Cheyenne, WY 82001-3214 | 2009-10-03 |
| 1114164175 | Todd Hamilton Burdick | Psychologist | 5601 Canyon Rd, Cheyenne, WY 82009-4545 | 2009-01-13 |
| 1235279498 | Love Care & Dignity, Inc. | Psychologist | 3344 Ridge Rd, Cheyenne, WY 82001-1734 | 2007-02-07 |
| 1194895359 | Magic City Enterprises, Inc | Psychologist | 1780 Westland Rd, Cheyenne, WY 82001-3322 | 2006-11-08 |
| 1144399056 | John R Sink | Psychologist | 1700 Westland Rd, Cheyenne, WY 82001-3322 | 2006-11-07 |
| 1639196561 | Gerald Joseph Post | Psychologist | 1401 Airport Parkway, Suite 120, Cheyenne, WY 82001 | 2006-07-16 |
| Find all providers in CHEYENNE | ||||
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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.