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General NPI Number Information
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NPI Number | 1124769401
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Entity Type | Individual
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Provider Name | ELLEN FRANCES DEEGAN
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Gender | Female
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Dates
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Enumeration Date | 04/02/2022
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Last Update Date | 08/28/2025
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Provider Practice Location Address
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Address Line | 217 S 1ST ST
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City | LARAMIE
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State | WY
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Zip | 82070-3605
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Country | US
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Telephone | 307-223-2172
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Fax |
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Provider Business Mailing Address
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Address Line | 803 REYNOLDS ST
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City | LARAMIE
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State | WY
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Zip | 82072-2176
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | LPC-1881
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License Number State | WY
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LPC-1881
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License Number State | WY
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