MEDICARE: CENTRAL WYOMING COUNSELING CENTER

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	320800000X	Mental Illness Community Based Residential Treatment Facility
2	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

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

General Provider Information

NPI Number	:	1730183617
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CENTRAL WYOMING COUNSELING CENTER

Provider Business Mailing Address
First Line	:	1430 WILKINS CIR
Second Line	:
City	:	CASPER
State	:	WY
Zip	:	82601-1336
Country	:	US
Telephone Number	:	307-237-9583
Fax Number	:	307-265-7277

Provider Business Practice Location Address
First Line	:	1430 WILKINS CIR
Second Line	:
City	:	CASPER
State	:	WY
Zip	:	82601-1336
Country	:	US
Telephone Number	:	307-237-9583
Fax Number	:	307-265-7277

Authorized Official
Title or Position	:	CHIEF FINANCIAL OFFICER
Name	:	BRANDON WHITE
Credential	:
Telephone Number	:	307-237-9583

Provider Enumeration Date	:	06/09/2005
Last Update Date	:	03/25/2025

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Directions to “CENTRAL WYOMING COUNSELING CENTER ” Practice Location

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