Mourning Glory Counseling Llc | |
1300 E A St Ste 201 Casper WY 82601-2252 | |
(307) 235-3333 | |
(307) 266-5155 |
Full Name | Mourning Glory Counseling Llc |
---|---|
Speciality | Social Worker - Clinical |
Location | 1300 E A St Ste 201, Casper, Wyoming |
Authorized Official Name and Position | Tisa M Sucher (LICENSED CLINICAL SOCIAL WORKER) |
Authorized Official Contact | 3072353333 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Mourning Glory Counseling Llc 1300 E A St Ste 201 Casper WY 82601-2252 Ph: (307) 235-3333 | Mourning Glory Counseling Llc 1300 E A St Ste 201 Casper WY 82601-2252 Ph: (307) 235-3333 |
NPI Number | 1902340326 |
---|---|
Provider Enumeration Date | 12/05/2016 |
Last Update Date | 12/05/2016 |
Identifier | Type | State | Issuer |
---|---|---|---|
1902340326 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1041C0700X | Social Worker - Clinical | 456 (Wyoming) | Primary |
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