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NPI Code Detail

MEDICARE: FREMONT COUNSELING SERVICE

MEDICARE: FREMONT COUNSELING SERVICE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QR0405XSubstance Use Disorder Rehabilitation Clinic/Center
2171M00000XCase Manager/Care Coordinator
3261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)

Other Identifiers

General Provider Information

NPI Number : 1003812694
Entity Type Code : Organization
Provider Name (Legal Business Name) : FREMONT COUNSELING SERVICE
Provider Business Mailing Address
First Line : 748 MAIN ST
Second Line :
City : LANDER
State : WY
Zip : 82520-3036
Country : US
Telephone Number : 307-332-2231
Fax Number : 307-332-9338
Provider Business Practice Location Address
First Line : 748 MAIN ST
Second Line :
City : LANDER
State : WY
Zip : 82520-3036
Country : US
Telephone Number : 307-332-2231
Fax Number : 307-332-9338
Authorized Official
Title or Position : EXECUTIVE DIRECTOR
Name : MR. SCOTT HAYES
Credential :
Telephone Number : 307-332-2231
Provider Enumeration Date : 06/28/2005
Last Update Date : 02/04/2016

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LANDER, WY
82520-3036
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1952628232 — KALSANG CHODON MS, PPC
Practice Location Address:
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LANDER, WY
82520-3036
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1215221676 — MS. CHRISTINE SIALIA PARR B.S. IN ED.
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Practice Fax: 307-332-9338

Directions to “FREMONT COUNSELING SERVICE ” Practice Location

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