=====================================================
General NPI Number Information
=====================================================
NPI Number | 1841891017
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CARING CONVERSATIONS COUNSELING LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/04/2020
-----------------------------------------------------
Last Update Date | 11/04/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3611 DOVER RD
-----------------------------------------------------
City | CHEYENNE
-----------------------------------------------------
State | WY
-----------------------------------------------------
Zip | 82001-1604
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 307-514-2029
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 1713
-----------------------------------------------------
City | CHEYENNE
-----------------------------------------------------
State | WY
-----------------------------------------------------
Zip | 82003-1713
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 307-514-2029
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | DANNY RUIZ
-----------------------------------------------------
Credential | LCSW
-----------------------------------------------------
Telephone | 307-514-2029
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------