Healthcare Provider Details

I. General information

NPI: 1861971707
Provider Name (Legal Business Name): MISTY A SAIN LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/10/2018
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2632 FOOTHILL BLVD STE 208
ROCK SPRINGS WY
82901-4758
US

IV. Provider business mailing address

1107 VIEW ST
ROCK SPRINGS WY
82901-4762
US

V. Phone/Fax

Practice location:
  • Phone: 307-350-1579
  • Fax:
Mailing address:
  • Phone: 307-350-1579
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLPC-2342
License Number StateWY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: