MEDICARE: WITH EAGLES WINGS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	101YP2500X	Professional Counselor
2	103TC0700X	Clinical Psychologist
3	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)
4	261QR0405X	Substance Use Disorder Rehabilitation Clinic/Center

General Provider Information

NPI Number	:	1801869169
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WITH EAGLES WINGS

Provider Business Mailing Address
First Line	:	PO BOX 197
Second Line	:
City	:	ST STEPHENS
State	:	WY
Zip	:	82524
Country	:	US
Telephone Number	:	307-857-5940
Fax Number	:	307-857-5932

Provider Business Practice Location Address
First Line	:	11 GREAT PLAINS RD
Second Line	:
City	:	ARAPAHO
State	:	WY
Zip	:	82510
Country	:	US
Telephone Number	:	307-857-5940
Fax Number	:	307-857-5932

Authorized Official
Title or Position	:	DIRECTOR OF WITH EAGLES WINGS
Name	:	DR. LEON WAKEFIELD
Credential	:
Telephone Number	:	307-857-5930

Provider Enumeration Date	:	02/08/2006
Last Update Date	:	09/11/2025

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Directions to “WITH EAGLES WINGS ” Practice Location

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