Healthcare Provider Details

I. General information

NPI: 1255184396
Provider Name (Legal Business Name): COUNSELING COALITION, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/09/2024
Last Update Date: 03/17/2025
Certification Date: 03/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 E 4TH ST STE 9
GILLETTE WY
82716-4061
US

IV. Provider business mailing address

PO BOX 7243
GILLETTE WY
82717-7243
US

V. Phone/Fax

Practice location:
  • Phone: 307-257-2290
  • Fax: 877-341-0234
Mailing address:
  • Phone: 970-217-2969
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QR0800X
TaxonomyRecovery Care Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: SARAH LOUISE HAYWORTH
Title or Position: OWNER
Credential: LPC
Phone: 970-217-2969