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General NPI Number Information
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NPI Number | 1205345931
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Entity Type | Organization
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Legal Business Name | SOUTHWEST COUNSELING SERVICE
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Dates
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Enumeration Date | 09/26/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 2706 ANKENY WAY
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City | ROCK SPRINGS
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State | WY
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Zip | 82901-5649
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Country | US
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Telephone | 307-352-6677
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Fax |
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Provider Business Mailing Address
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Address Line | 2706 ANKENY WAY
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City | ROCK SPRINGS
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State | WY
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Zip | 82901-5649
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Country | US
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Telephone | 307-352-6677
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MS. LINDA ACKER
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Credential | MA, LPC
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Telephone | 307-352-6677
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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