Healthcare Provider Details

I. General information

NPI: 1780487595
Provider Name (Legal Business Name): TWIN PINES COUNSELING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/28/2025
Last Update Date: 03/28/2025
Certification Date: 03/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 N GOULD ST STE 48715
SHERIDAN WY
82801-6317
US

IV. Provider business mailing address

30 N GOULD ST STE 48715
SHERIDAN WY
82801-6317
US

V. Phone/Fax

Practice location:
  • Phone: 307-453-0915
  • Fax:
Mailing address:
  • Phone: 307-453-0915
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: SEAN LESTER
Title or Position: COUNSELOR
Credential: LPC
Phone: 307-453-0915