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NPI Code Detail

MEDICARE: MS. JOELLEN JORGENSEN MED, LPC, NCC, RPT-S

MEDICARE:  MS. JOELLEN  JORGENSEN  MED, LPC, NCC, RPT-S
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
1101YP2500XProfessional Counselor1128WY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1JOR314531OTHERWYBCBS

General Provider Information

NPI Number : 1780889907
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. JOELLEN JORGENSEN MED, LPC, NCC, RPT-S
Provider Business Mailing Address
First Line : 800 WERNER CT STE 235
Second Line :
City : CASPER
State : WY
Zip : 82601-1361
Country : US
Telephone Number : 307-233-4212
Fax Number : 307-233-4213
Provider Business Practice Location Address
First Line : 800 WERNER CT
Second Line : SUITE 235
City : CASPER
State : WY
Zip : 82601-1326
Country : US
Telephone Number : 307-233-4212
Fax Number : 307-233-4213
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/18/2007
Last Update Date : 03/13/2013

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Directions to “ MS. JOELLEN JORGENSEN MED, LPC, NCC, RPT-S” Practice Location

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