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General NPI Number Information
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NPI Number | 1134769581
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Entity Type | Individual
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Provider Name | LESLIE URBANEK
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Gender | Female
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Dates
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Enumeration Date | 01/14/2020
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Last Update Date | 12/07/2023
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Provider Practice Location Address
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Address Line | 623 W 20TH ST
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City | CHEYENNE
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State | WY
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Zip | 82001-3501
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Country | US
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Telephone | 307-222-2013
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Fax | 307-316-8792
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Provider Business Mailing Address
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Address Line | PO BOX 1842
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City | CHEYENNE
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State | WY
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Zip | 82003-1842
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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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-2189
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License Number State | WY
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Taxonomy #3
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | PPC-1171
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License Number State | WY
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