Healthcare Provider Details
I. General information
NPI: 1093627101
Provider Name (Legal Business Name): CENTRAL WYOMING COUNSELING CENTER
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/22/2026
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1110 MAJOR AVE
RIVERTON WY
82501-2342
US
IV. Provider business mailing address
1430 WILKINS CIR
CASPER WY
82601-1336
US
V. Phone/Fax
- Phone: 307-237-9583
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QM0801X |
| Taxonomy | Mental Health Clinic/Center (Including Community Mental Health Center) |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QR0800X |
| Taxonomy | Recovery Care Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
VALERIE
FOSTER
Title or Position: REVENUE CYCLE MANAGER
Credential:
Phone: 307-237-9583