Healthcare Provider Details

I. General information

NPI: 1679047922
Provider Name (Legal Business Name): AMY DARLENE WEBER LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/18/2019
Last Update Date: 06/18/2025
Certification Date: 06/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

542 RUNNING W DR
GILLETTE WY
82718-2074
US

IV. Provider business mailing address

542 RUNNING W DR
GILLETTE WY
82718-2074
US

V. Phone/Fax

Practice location:
  • Phone: 307-257-2331
  • Fax: 307-670-8042
Mailing address:
  • Phone: 307-257-2331
  • Fax: 307-670-8042

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberPPC-1148
License Number StateWY
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLPC-1948
License Number StateWY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: