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NPI Code Detail

MEDICARE: TRAUMA AND BEYOND - WELLNESS CENTER LLC

MEDICARE: TRAUMA AND BEYOND - WELLNESS CENTER 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
1101YM0800XMental Health Counselor
21041C0700XClinical Social Worker

General Provider Information

NPI Number : 1760107817
Entity Type Code : Organization
Provider Name (Legal Business Name) : TRAUMA AND BEYOND - WELLNESS CENTER LLC
Provider Business Mailing Address
First Line : 3677 PATRICK RD
Second Line :
City : CHEYENNE
State : WY
Zip : 82007-1177
Country : US
Telephone Number : 307-287-1170
Fax Number :
Provider Business Practice Location Address
First Line : 2710 THOMES AVE
Second Line :
City : CHEYENNE
State : WY
Zip : 82001-3029
Country : US
Telephone Number : 307-200-7184
Fax Number :
Authorized Official
Title or Position : CEO
Name : LAUREN SMITH
Credential : LCSW
Telephone Number : 307-200-7184
Provider Enumeration Date : 10/11/2022
Last Update Date : 03/29/2026

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