DR. BRYAN K MICKELSON (NPI# 1033440466) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033440466 |
| Entity Type | Individual |
| Full Name | DR. BRYAN K MICKELSON |
| Credential | PH.D. |
| Practice Address |
120 S 17th St Worland WY 82401-3637 |
| Mailing Address |
Po Box 605 Worland WY 82401-0605 |
| Practice Telephone | 3072725368 |
| Practice Fax Number | 3073474038 |
| Mailing Telephone | 3072725368 |
| Mailing Fax Number | 3073474038 |
| Enumeration Date | 2010-01-25 |
| Last Update Date | 2015-05-07 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 103T00000X | Psychologist | Behavioral Health & Social Service Providers | ||
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
#535 | WY | Behavioral Health & Social Service Providers |
| N | 103TC1900X |
Psychologist Specialization: Counseling |
Behavioral Health & Social Service Providers | ||
| N | 103TC2200X |
Psychologist Specialization: Clinical Child & Adolescent |
Behavioral Health & Social Service Providers | ||
| N | 103TP2701X |
Psychologist Specialization: Group Psychotherapy |
Behavioral Health & Social Service Providers | ||
| N | 103TS0200X |
Psychologist Specialization: School |
Behavioral Health & Social Service Providers |
| Street Address |
120 S 17TH ST |
| City | WORLAND |
| State | WY |
| Zip Code | 82401-3637 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326062852 | First Choice Physical Therapy, P.C. | Physical Therapist | 120 S 17th St, Worland, WY 82401 | 2006-07-27 |
| 1114394004 | Alyssa Rae Keller | Physical Therapy Assistant | 120 S 17th St, Worland, WY 82401-3637 | 2015-08-26 |
| 1366860942 | Worland Physical Therapy | Clinic/Center | 120 S 17th St, Worland, WY 82401-3637 | 2014-04-01 |
| 1396174264 | Charles Wassum | Physical Therapist | 120 S 17th St, Worland, WY 82401-3637 | 2013-11-01 |
| 1134562580 | Preston Page Harman | Physical Therapist | 120 S 17th St, Worland, WY 82401-3637 | 2013-04-15 |
| 1851627210 | Janae B Harman | Counselor | 120 S 17th St, Worland, WY 82401-3637 | 2009-10-20 |
| 1699870246 | Laura M Wolski | Physical Therapist | 120 S 17th St, Worland, WY 82401-3637 | 2006-09-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386284107 | Margaret Joan Mcdaniel | Registered Nurse | 1910 Sage Crossing Ave, Worland, WY 82401 | 2020-01-09 |
| 1902365240 | Worland Pharmacy Inc. | Pharmacy | 1095 Circle Rd, Worland, WY 82401 | 2019-03-17 |
| 1023547155 | Deborah J Anderson | Counselor | 401 South 23rd St, Worland, WY 82401 | 2017-06-12 |
| 1265808273 | Tang Mo Wong | Occupational Therapist | 1910 Howell Avenue, Worland, WY 82401 | 2015-08-12 |
| 1063783389 | William Jonas Tempany | Counselor | 406 S 6, Basin, WY 82401 | 2012-01-18 |
| 1609009133 | Sharon Eisele | Case Manager/Care Coordinator | 1216 Ti Bi Yek, Worland, WY 82401 | 2009-09-01 |
| 1295997013 | Benjamin B Wilde | Family Medicine | 1405 Howell, Worland, WY 82401 | 2008-07-02 |
| 1134390552 | Linda Kay Hausner | Registered Nurse | 401 South 23rd Street, 401 South 23rd Street, Worland, WY 82401 | 2008-03-13 |
| 1033302047 | Lisa Anne Stephens | Physical Therapist | 1313 Big Horn Ave, Worland, WY 82401 | 2007-08-22 |
| 1316147952 | Jeffries Dental, P.C. | Dentist | 3313 Paintbrush Lane, Worland, WY 82401 | 2007-07-23 |
| Find all providers in zip 82401 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487899555 | Paula Serra Gross | Psychologist | 1819 Cloud Peak Dr, Worland, WY 82401-2514 | 2008-12-03 |
| 1831353812 | Wayne Rusty Reynolds | Psychologist | 1123 Big Horn Ave Ste A, Worland, WY 82401-2814 | 2008-07-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639700750 | Unaccompanied Student Initiative | Psychologist | 910 W Fox Farm Rd, Cheyenne, WY 82007-2674 | 2020-01-28 |
| 1730731696 | Shaina Smith | Psychologist | 1401 Airport Pkwy Ste 240, Cheyenne, WY 82001-1542 | 2019-07-11 |
| 1538623020 | Caitilin Barrett | Psychologist | 1215 Jessi Dr, Cheyenne, WY 82009-1880 | 2019-01-29 |
| 1043756174 | Maribeth L. Hesser | Psychologist | 6675 N Upper Cascade Dr, Jackson, WY 83001-9390 | 2017-01-12 |
| 1811346943 | Bryan David Peltier | Psychologist | 125 Fox Hills Dr, Green River, WY 82935-7100 | 2016-06-09 |
| 1558760207 | Victoria Menghetti Smith | Psychologist | 3510 N Lake Creek Dr, Wilson, WY 83014-9695 | 2014-08-19 |
| 1508283946 | Christine Mckibbin | Psychologist | 2524 Dover Dr, Laramie, WY 82072-2990 | 2014-03-24 |
| 1609140706 | Casper Family Connections | Psychologist | 500 S Wolcott St Ste 102, Casper, WY 82601-2882 | 2012-03-07 |
| 1417246869 | John C Dolores | Psychologist | 5303 Mountain Rd, Apt C, Cheyenne, WY 82009-5049 | 2011-04-06 |
| 1164726766 | Marc Douglas Mclaughlin | Psychologist | 205 S Broadway Ave, Riverton, WY 82501-4349 | 2010-12-22 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.