Healthcare Provider Details

I. General information

NPI: 1780192252
Provider Name (Legal Business Name): NEW HOPE COUNSELING AND CONSULTING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/17/2018
Last Update Date: 01/19/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

306 PARK AVE
WHEATLAND WY
82201-3324
US

IV. Provider business mailing address

2407 FERTIG DR
WHEATLAND WY
82201-2146
US

V. Phone/Fax

Practice location:
  • Phone: 307-331-7787
  • Fax:
Mailing address:
  • Phone: 307-331-7787
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number1447
License Number StateWY
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number1447
License Number StateWY
# 3
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number1447
License Number StateWY

VIII. Authorized Official

Name: KARI MAGNUSON
Title or Position: COUNSELOR
Credential:
Phone: 307-331-7787