Healthcare Provider Details

I. General information

NPI: 1902037641
Provider Name (Legal Business Name): CYNTHIA HAMANN, MSW, LCSW, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/29/2009
Last Update Date: 07/29/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2345 E 2ND ST
CASPER WY
82609-2048
US

IV. Provider business mailing address

2345 E 2ND ST
CASPER WY
82609-2048
US

V. Phone/Fax

Practice location:
  • Phone: 307-235-3333
  • Fax: 307-266-5155
Mailing address:
  • Phone: 307-235-3333
  • Fax: 307-266-5155

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW-205
License Number StateWY

VIII. Authorized Official

Name: MS. CYNTHIA HAMANN
Title or Position: PRESIDENT
Credential: MSW, LCSW
Phone: 307-235-3333