Healthcare Provider Details

I. General information

NPI: 1063102408
Provider Name (Legal Business Name): NEW DAY COUNSELING & PLAY THERAPY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/09/2023
Last Update Date: 05/09/2023
Certification Date: 05/09/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

160 S 4TH ST
LANDER WY
82520-3112
US

IV. Provider business mailing address

PO BOX 676
LANDER WY
82520-0676
US

V. Phone/Fax

Practice location:
  • Phone: 307-438-3384
  • Fax:
Mailing address:
  • Phone: 307-438-3384
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name: KARI THERESA DAY
Title or Position: PROFESSIONAL COUNSELOR
Credential: LPC
Phone: 307-438-3384