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NPI Code Detail

MEDICARE: MS. JANE ANN WARREN PHD

MEDICARE: MS. JANE ANN WARREN PHD
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
1101YA0400XAddiction (Substance Use Disorder) CounselorLAT 031WY
2106H00000XMarriage & Family TherapistLMFT028WY
3101YP2500XProfessional Counselor194WY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1310803OTHERWYBS

General Provider Information

NPI Number : 1780685594
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. JANE ANN WARREN PHD
Provider Business Mailing Address
First Line : 1203 E PARK AVE
Second Line :
City : LARAMIE
State : WY
Zip : 82070-4112
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1263 N 15TH ST
Second Line :
City : LARAMIE
State : WY
Zip : 82072-2343
Country : US
Telephone Number : 307-745-8915
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/02/2005
Last Update Date : 09/11/2025

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Directions to “ MS. JANE ANN WARREN PHD” Practice Location

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