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1356588727

NPI Code Detail

MEDICARE: CATHEDRAL HOME FOR CHILDREN

MEDICARE: CATHEDRAL HOME FOR CHILDREN

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	2084P0804X	Child & Adolescent Psychiatry Physician
2	261QR0405X	Substance Use Disorder Rehabilitation Clinic/Center
3	103TF0000X	Family Psychologist
4	251S00000X	Community/Behavioral Health Agency
5	103TC2200X	Clinical Child & Adolescent Psychologist
6	101YP2500X	Professional Counselor
7	323P00000X	Psychiatric Residential Treatment Facility
8	261QM0855X	Adolescent and Children Mental Health Clinic/Center
9	320800000X	Mental Illness Community Based Residential Treatment Facility	118869104	WY
10	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)
11	3245S0500X	Children's Substance Abuse Rehabilitation Facility	118869104	WY
12	322D00000X	Emotionally Disturbed Childrens' Residential Treatment Facility
13	106H00000X	Marriage & Family Therapist
14	2084P0800X	Psychiatry Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1356588727
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CATHEDRAL HOME FOR CHILDREN

Provider Business Mailing Address
First Line	:	4989 N 3RD ST
Second Line	:
City	:	LARAMIE
State	:	WY
Zip	:	82072-9548
Country	:	US
Telephone Number	:	307-745-8997
Fax Number	:	307-742-6146

Provider Business Practice Location Address
First Line	:	4989 N 3RD ST
Second Line	:
City	:	LARAMIE
State	:	WY
Zip	:	82072-9548
Country	:	US
Telephone Number	:	307-640-6123
Fax Number	:

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	MRS. NICOLE HAUSER
Credential	:	MSW, LCSW
Telephone Number	:	307-745-8997

Provider Enumeration Date	:	01/07/2009
Last Update Date	:	09/04/2025

Similar Medicare Providers

1023100336 — MS. BROOKE LYNN BENSON M.S., LPC, NCC
Practice Location Address:

4989 N 3RD ST
LARAMIE, WY
82072-9548

Practice Phone: 307-745-8997
Practice Fax:

1033206289 — CATHEDRAL HOME FOR CHILDREN
Practice Location Address:

4989 N 3RD ST
LARAMIE, WY
82072-9548

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1528213477 — MS. JAMIE LYNN RETTINGER MA
Practice Location Address:

4989 N 3RD ST
LARAMIE, WY
82072-9548

Practice Phone: 307-745-8997
Practice Fax:

1356673297 — AARON LOZANO M.S.
Practice Location Address:

4989 N 3RD ST
LARAMIE, WY
82072-9548

Practice Phone: 307-745-8997
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1134400328 — ANNEMARI BRADIN PPC
Practice Location Address:

4989 N 3RD ST
LARAMIE, WY
82072-9548

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Practice Fax:

1831470004 — CHRIS HARNDEN LPC
Practice Location Address:

4989 N 3RD ST
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82072-9548

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Directions to “CATHEDRAL HOME FOR CHILDREN ” 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.

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