KELLY L HEENAN (NPI# 1093938839) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093938839 |
| Entity Type | Individual |
| Full Name | KELLY L HEENAN |
| Other Name | KELLY L BACKHAUS |
| Credential | PHD |
| Practice Address |
3741 Arroyo Drive Casper WY 82604 |
| Practice Telephone | 3074722995 |
| Mailing Telephone | 3074722995 |
| Enumeration Date | 2007-04-10 |
| Last Update Date | 2011-10-21 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YP2500X |
Counselor Specialization: Professional |
LPC - 1073 | WY | Behavioral Health & Social Service Providers |
| N | 101YP2500X |
Counselor Specialization: Professional |
62396 | TX | Behavioral Health & Social Service Providers |
| Y | 106H00000X | Marriage & Family Therapist | LMFT -139 | WY | Behavioral Health & Social Service Providers |
| N | 106H00000X | Marriage & Family Therapist | 201042 | TX | Behavioral Health & Social Service Providers |
| Street Address |
3741 ARROYO DRIVE |
| City | CASPER |
| State | WY |
| Zip Code | 82604 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518489335 | Sasha Marie Baker | Behavior Technician | 945 Pendell Blvd, Casper, WY 82604 | 2017-07-13 |
| 1083161566 | Lori Norby | Registered Nurse | 6641 Monarch Ct, Casper, WY 82604 | 2016-09-01 |
| 1245601020 | Living for A Change LLC | Social Worker | 2045 Laramie Ave, Casper, WY 82604 | 2015-10-19 |
| 1225406754 | Patricia Masters | Respite Care | 6678 Bailey Place, Casper, WY 82604 | 2015-09-15 |
| 1619364437 | Daniel Dalen | Specialist/Technologist | 2342 Odell, Casper, WY 82604 | 2015-04-20 |
| 1568883064 | Rocky Mountain Holdings, LLC | Ambulance | 7798 Fuller St, Casper, WY 82604 | 2013-12-31 |
| 1902191638 | Diana Pauline Quealy-berge | Counselor | 3920 Swingle, Casper, WY 82604 | 2011-06-10 |
| 1649393943 | Leslie Keeler | Case Manager/Care Coordinator | 630 10 Mile Road, Casper, WY 82604 | 2007-04-09 |
| 1386778223 | Wyoming Health Fairs | Technician, Pathology | 115 South Elm St, Casper, WY 82604 | 2007-03-15 |
| 1487786836 | Wal Mart Stores, Inc. Dba Wal-mart | Technician/Technologist | 4255 Cy Avenue, Casper (w), WY 82604 | 2007-03-12 |
| Find all providers in zip 82604 | ||||
| Taxonomy Code | 106H00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Marriage & Family Therapist |
| A marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives supervised clinical experience, or a person who meets the state requirements to practice as a marriage and family therapist. A marriage and family therapist treats mental and emotional disorders within the context of marriage and family systems. A marriage and family therapist provides mental health and counseling services to individuals, couples, families, and groups. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093939597 | Lynn Widdison Scott | Marriage & Family Therapist | 1115 Beaumont Dr, Casper, WY 82601-5908 | 2007-04-13 |
| 1821347527 | Ginger Allen Terry | Marriage & Family Therapist | 5725 Highland Dr, Casper, WY 82609-4382 | 2012-09-10 |
| 1427324581 | Life's Journey Counseling Service, LLC | Marriage & Family Therapist | 1300 E A St, Suite 201-b, Casper, WY 82601-2260 | 2012-03-22 |
| 1174761340 | Dama Wimbish Matchett | Marriage & Family Therapist | 1300 E A St, Suite 201-b, Casper, WY 82601-2260 | 2009-01-27 |
| 1316123904 | Robert Denis Knowles | Marriage & Family Therapist | 1430 Wilkins Cir, Casper, WY 82601-1336 | 2008-01-14 |
| 1982748794 | Karen Sue Nay | Marriage & Family Therapist | 1430 Wilkins Cir, Casper, WY 82601-1336 | 2007-02-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043854888 | Wayne Kenneth Mcpherson Jr. | Marriage & Family Therapist | 512 W. Lott, Buffalo, WY 82834-1336 | 2019-11-05 |
| 1700341914 | Heidi Christine Somers | Marriage & Family Therapist | 330 N Glenwood St, Jackson, WY 83001-8765 | 2019-02-01 |
| 1275067811 | High Point Counseling | Marriage & Family Therapist | 2632 Foothill Blvd Ste 101, Rock Springs, WY 82901-4757 | 2017-04-19 |
| 1770939928 | Allison Felker | Marriage & Family Therapist | 4720 Spur Dr, Cheyenne, WY 82001-6493 | 2016-05-06 |
| 1477934586 | Auburn Amanda Robertson | Marriage & Family Therapist | 1013 Sage St, Evanston, WY 82930-3448 | 2015-06-15 |
| 1306261102 | Kellie Fitzgibbons | Marriage & Family Therapist | 1701 Stampede Ave Ste 205, Cody, WY 82414-4818 | 2014-03-03 |
| 1003238718 | Jessica Zamudio Bright | Marriage & Family Therapist | 1800 Edinburgh Street, Rawlins, WY 82301 | 2014-01-15 |
| 1750637393 | John Darris Ellis | Marriage & Family Therapist | Yellowstone Behavioral Health 2538 Big Horn Ave, Cody Office, Cody, WY 82414-9299 | 2012-08-01 |
| 1366797896 | Robin K. Voigt, LLC | Marriage & Family Therapist | 405 West Boxelder Rd, C8, Gillette, WY 82718-5320 | 2012-07-20 |
| 1386947877 | Deann Fox | Marriage & Family Therapist | 1775 Spring Creek Rd, Cheyenne, WY 82009-8846 | 2010-12-06 |
| 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.