Healthcare Provider Details

I. General information

NPI: 1134023708
Provider Name (Legal Business Name): TIMOTHY PAUL ADAMS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/06/2026
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1300 E A ST STE 201
CASPER WY
82601-2252
US

IV. Provider business mailing address

3701 S COFFMAN AVE
CASPER WY
82604-4977
US

V. Phone/Fax

Practice location:
  • Phone: 307-235-3333
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberPPC-1506
License Number StateWY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: