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General NPI Number Information
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NPI Number | 1518800770
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Entity Type | Organization
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Legal Business Name | MOURNING DOVE GRIEF CARE LLC
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Dates
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Enumeration Date | 04/13/2026
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Last Update Date | 04/13/2026
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Provider Practice Location Address
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Address Line | 245 S FENWAY ST
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City | CASPER
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State | WY
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Zip | 82601-3026
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Country | US
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Telephone | 307-577-4832
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Fax | 307-577-4841
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Provider Business Mailing Address
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Address Line | 319 S WILSON ST
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City | CASPER
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State | WY
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Zip | 82601-2943
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Country | US
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Telephone | 307-577-4832
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Fax | 307-577-4841
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | KILTY BROWN
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Credential |
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Telephone | 307-577-4832
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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 |
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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 |
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License Number State |
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