Healthcare Provider Details

I. General information

NPI: 1689551178
Provider Name (Legal Business Name): MEFFORD LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/18/2025
Last Update Date: 09/04/2025
Certification Date: 09/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 WARREN AVE
GILLETTE WY
82716-3728
US

IV. Provider business mailing address

4300 TATE CT
GILLETTE WY
82718-4180
US

V. Phone/Fax

Practice location:
  • Phone: 307-680-1057
  • Fax: 307-682-2968
Mailing address:
  • Phone: 307-680-1057
  • Fax: 307-682-2968

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: TRISHA A KLEIBOEKER
Title or Position: OFFICE MANAGER
Credential:
Phone: 307-682-2034