Healthcare Provider Details

I. General information

NPI: 1316760242
Provider Name (Legal Business Name): CORTNEY ANNA OSBORN LPC-2605, NCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/07/2024
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

821 W PERSHING BLVD
CHEYENNE WY
82001-2537
US

IV. Provider business mailing address

821 W PERSHING BLVD
CHEYENNE WY
82001-2537
US

V. Phone/Fax

Practice location:
  • Phone: 307-421-9329
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC-2605
License Number StateWY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: