MEDICARE: DANIEL A BORT LPC, LAT

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
1	101YM0800X	Mental Health Counselor	LPC986	WY
2	101YA0400X	Addiction (Substance Use Disorder) Counselor	LPC986, LAT333	WY
3	101YP2500X	Professional Counselor	LPC-986	WY

General Provider Information

NPI Number	:	1114148020
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANIEL A BORT LPC, LAT

Provider Business Mailing Address
First Line	:	4025 RAWLINS ST
Second Line	:
City	:	CHEYENNE
State	:	WY
Zip	:	82001-1900
Country	:	US
Telephone Number	:	307-426-4798
Fax Number	:	307-426-4799

Provider Business Practice Location Address
First Line	:	4025 RAWLINS ST
Second Line	:
City	:	CHEYENNE
State	:	WY
Zip	:	82001-1900
Country	:	US
Telephone Number	:	307-426-4798
Fax Number	:	307-426-4799

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/01/2007
Last Update Date	:	09/09/2015

Similar Medicare Providers

1861322885 — JACOB PRESTON
Practice Location Address:

4025 RAWLINS ST
CHEYENNE, WY
82001-1900

Practice Phone: 307-426-4797
Practice Fax:

1538097126 — OLIVIA JOYCE WILLIAMS
Practice Location Address:

4025 RAWLINS ST
CHEYENNE, WY
82001-1900

Practice Phone: 307-426-4798
Practice Fax:

1124108931 — MRS. STEPHANIE LIN KELLER CSW-099
Practice Location Address:

4025 RAWLINS ST
CHEYENNE, WY
82001-1900

Practice Phone: 307-426-4798
Practice Fax: 307-426-4799

1134342199 — ROBERT A LOGAN LPC
Practice Location Address:

4025 RAWLINS STREET
CHEYENNE, WY
82001-1900

Practice Phone: 307-275-2483
Practice Fax: 307-426-4799

1942490792 — AMY M MAVY LCSW
Practice Location Address:

4025 RAWLINS ST
CHEYENNE, WY
82001-1900

Practice Phone: 307-426-4797
Practice Fax:

1174714232 — NIKOLAI BREITKOPF MSPT
Practice Location Address:

1900 CONVERSE AVE
CHEYENNE, WY
82001-4112

Practice Phone: 307-514-2411
Practice Fax: 307-514-2392

Directions to “ DANIEL A BORT LPC, LAT” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.