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NPI Code Detail

MEDICARE: SUNSHINE COUNSELING LLC

MEDICARE: SUNSHINE COUNSELING LLC
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
1251S00000XCommunity/Behavioral Health AgencyLCSW-972WY

General Provider Information

NPI Number : 1295278851
Entity Type Code : Organization
Provider Name (Legal Business Name) : SUNSHINE COUNSELING LLC
Provider Business Mailing Address
First Line : 1541 DIAMOND DR
Second Line :
City : CASPER
State : WY
Zip : 82601-6247
Country : US
Telephone Number : 307-224-2060
Fax Number : 307-224-2060
Provider Business Practice Location Address
First Line : 1541 DIAMOND DR
Second Line :
City : CASPER
State : WY
Zip : 82601-6247
Country : US
Telephone Number : 307-224-2060
Fax Number : 307-224-2060
Authorized Official
Title or Position : THERAPIST
Name : JAN L DEMOULIN
Credential : LCSW
Telephone Number : 307-224-2060
Provider Enumeration Date : 11/29/2016
Last Update Date : 11/29/2016

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Directions to “SUNSHINE COUNSELING LLC ” Practice Location

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