NORTHERN WYOMING MENTAL HEALTH CENTER, INC. (NPI# 1124302005) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124302005 |
| Entity Type | Organization |
| Organization Name | NORTHERN WYOMING MENTAL HEALTH CENTER, INC. |
| Practice Address |
420 1/2 Main St Sundance WY 82729 |
| Mailing Address |
Po Box 646 Sundance WY 82729-0646 |
| Practice Telephone | 3072833636 |
| Practice Fax Number | 3072832898 |
| Mailing Telephone | 3072833636 |
| Mailing Fax Number | 3072832898 |
| Enumeration Date | 2011-10-10 |
| Last Update Date | 2020-10-22 |
| Authorized Official Name | PAUL E. DEMPLE (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Telephone | 3076728958 |
| Authorized Official Credential | MA, LPC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR0405X |
Clinic/Center Specialization: Rehabilitation, Substance Use Disorder |
WY | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WY | 106076707 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558415927 | Northern Wyoming Mental Health Center, Inc. | Clinic/Center | 420 1-2 Main St, Sundance, WY 82729-0646 | 2007-01-23 |
| 1386798239 | Northern Wyoming Mental Health Center, Inc. | Clinic/Center | 521 W Lott St, Buffalo, WY 82834-1642 | 2007-01-22 |
| 1013292473 | Northern Wyoming Mental Health Center, Inc. | Clinic/Center | 1221 W 5th St, Sheridan, WY 82801-2701 | 2011-10-18 |
| 1548545106 | Northern Wyoming Mental Health Center, Inc. | Clinic/Center | 521 W Lott St, Buffalo, WY 82834-1642 | 2011-10-14 |
| 1093090656 | Northern Wyoming Mental Health Center, Inc. | Clinic/Center | 1701 W 5th St, Suite C, Sheridan, WY 82801-2748 | 2011-10-14 |
| 1588948673 | Northern Wyoming Mental Health Center, Inc. | Clinic/Center | 420 Deanne Ave, Newcastle, WY 82701-2936 | 2011-10-06 |
| 1619021912 | Northern Wyoming Mental Health Center, Inc. | Clinic/Center | 1221 W 5th St, Sheridan, WY 82801-2701 | 2007-01-23 |
| 1952455834 | Northern Wyoming Mental Health Center, Inc. | Clinic/Center | 1701 W 5th St, Suite C, Sheridan, WY 82801-2748 | 2007-01-22 |
| Street Address |
420 1/2 MAIN ST |
| City | SUNDANCE |
| State | WY |
| Zip Code | 82729 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730706128 | Shenae Kayleen Lacroix | Physical Medicine & Rehabilitation | 2719 Wy-585, Sundance, WY 82729 | 2020-07-01 |
| 1245898642 | Katherine Suzanne Wilkins | Physical Therapist | 2719 State Hwy 585, Sundance, WY 82729 | 2019-05-31 |
| 1023445459 | Micki Dahne Lyons | Nurse Practitioner | 713 W. Oak Street, Sundance, WY 82729 | 2013-09-30 |
| 1033497425 | Lacey Waddell | Dietitian, Registered | 713 W Oak Street, Sundance, WY 82729 | 2011-08-02 |
| 1952433302 | Rita Larae Vannorman | Social Worker | 420 1/2 Main St., Sundance, WY 82729 | 2007-03-12 |
| 1720138910 | Cheryl Ann Wales | Counselor | 2101 Hwy 14, Sundance, WY 82729 | 2007-01-11 |
| 1902862295 | Veronica L Kramer | Physical Therapist | 226 South Hwy 585, Sundance, WY 82729 | 2006-04-25 |
| 1629476270 | Vilas Pharmacy | Pharmacy | 224 E Main Street, Sundance, WY 82729 | 2014-12-15 |
| 1366868150 | Brianne Wooldridge | Counselor | 405 Main St, Sundance, WY 82729 | 2014-03-17 |
| 1518081678 | Crook County Medical Services District | Family Medicine | 713 Oak Street, Sundance, WY 82729 | 2007-03-16 |
| Find all providers in zip 82729 | ||||
| Taxonomy Code | 261QR0405X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rehabilitation, Substance Use Disorder |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558837682 | Chrysalis Treatment Center, Inc. | Clinic/Center | 137 S Division St, Powell, WY 82435-2409 | 2018-10-16 |
| 1518346709 | High Country Behavioral Health | Clinic/Center | 1050 North Highway 414, Mountain View, WY 82939-0458 | 2015-05-21 |
| 1902213093 | White Buffalo Recovery Center | Clinic/Center | #22 Great Plains Rd, Arapahoe, WY 82510 | 2014-07-21 |
| 1255604856 | High Country Behavioral Health | Clinic/Center | 830 Highway 150 S, Evanston, WY 82930-5341 | 2012-02-14 |
| 1174805402 | High Country Behavioral Health | Clinic/Center | 190 Overthrust Rd., Evanston, WY 82931-2910 | 2011-09-13 |
| 1891099545 | High Country Behavioral Health | Clinic/Center | 75 Yellow Creek Rd., Ste 105, Evanston, WY 82930-5205 | 2011-01-10 |
| 1265751309 | Eastern Shoshone Recovery | Clinic/Center | #7 Shipton Lane, Fort Washakie, WY 82514-0538 | 2010-05-28 |
| 1881919751 | Shoshone & Arapaho Tribal Substance Abuse Court | Clinic/Center | 215 Ethete Rd, Fort Washakie, WY 82514 | 2010-04-02 |
| 1578765749 | With Eagle's Wings | Clinic/Center | 11 Great Plain Road, Arapahoe, WY 82524-0197 | 2007-06-01 |
| 1316151053 | Solutions for Life | Clinic/Center | 905 S Main St., Lusk, WY 82225 | 2007-05-10 |
| 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.