Healthcare Provider Details

I. General information

NPI: 1760834642
Provider Name (Legal Business Name): CYNTHIA ANN REPASKY MSW, PCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/05/2016
Last Update Date: 07/05/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

330 S CENTER ST SUITE #305
CASPER WY
82601-2840
US

IV. Provider business mailing address

330 S CENTER ST SUITE #305
CASPER WY
82601-2840
US

V. Phone/Fax

Practice location:
  • Phone: 307-277-6473
  • Fax: 888-659-0934
Mailing address:
  • Phone: 307-277-6473
  • Fax: 888-659-0934

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberPCSW-686
License Number StateWY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: