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General NPI Number Information
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NPI Number | 1114854924
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Entity Type | Organization
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Legal Business Name | POWDER RIVER COUNSELING AND WELLNESS
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Dates
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Enumeration Date | 05/06/2026
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Last Update Date | 05/06/2026
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Provider Practice Location Address
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Address Line | 100 WARREN AVE
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City | GILLETTE
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State | WY
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Zip | 82716-3728
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Country | US
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Telephone | 307-682-2034
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Fax | 307-682-2968
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Provider Business Mailing Address
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Address Line | 100 WARREN AVE
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City | GILLETTE
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State | WY
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Zip | 82716-3728
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Country | US
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Telephone | 307-682-2034
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Fax | 307-682-2968
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Authorized Official
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Title or Position | OWNER
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Name | KRISTINA LESLIE
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Credential | DBH, LBA, LMFT
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Telephone | 949-922-3043
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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