Healthcare Provider Details

I. General information

NPI: 1659775880
Provider Name (Legal Business Name): SARAH CATHERINE CLONCH MS, PPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/17/2014
Last Update Date: 03/18/2026
Certification Date: 03/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 BUTLER SPAETH RD
GILLETTE WY
82716-4612
US

IV. Provider business mailing address

PO BOX 3011
GILLETTE WY
82717-3011
US

V. Phone/Fax

Practice location:
  • Phone: 307-688-8700
  • Fax:
Mailing address:
  • Phone: 307-688-5000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC-2201
License Number StateWY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: