NORTHEAST WYOMING BOCES (NPI# 1275834467) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275834467 |
| Entity Type | Organization |
| Organization Name | NORTHEAST WYOMING BOCES |
| Practice Address |
410 N Miller Ave Gillette WY 82716-2929 |
| Practice Telephone | 3076820231 |
| Mailing Telephone | 3076820231 |
| Enumeration Date | 2010-11-04 |
| Last Update Date | 2010-11-04 |
| Authorized Official Name | KELLY TONN (PRINCIPAL) |
| Authorized Official Telephone | 3076860231 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101Y00000X | Counselor | Behavioral Health & Social Service Providers | ||
| N | 103TC0700X |
Psychologist Specialization: Clinical |
Behavioral Health & Social Service Providers | ||
| N | 2084P0805X |
Psychiatry & Neurology Specialization: Geriatric Psychiatry |
Allopathic & Osteopathic Physicians | ||
| N | 225100000X | Physical Therapist | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | ||
| N | 225X00000X | Occupational Therapist | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | ||
| N | 235Z00000X | Speech-Language Pathologist | Speech, Language and Hearing Service Providers | ||
| Y | 320600000X | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | Residential Treatment Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437328663 | Northeast Wyoming Boces | Residential Treatment Facility, Emotionally Disturbed Children | 410 N Miller Ave, Gillette, WY 82716-2929 | 2008-02-21 |
| 1841654860 | Northeast Wyoming Boces | Community/Behavioral Health | 410 N Miller Ave, Gillette, WY 82716-2929 | 2016-04-06 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | NORTHEAST WYOMING BOCES | 410 N Miller Ave, Gillette, WY 82716-2929 |
| Street Address |
410 N MILLER AVE |
| City | GILLETTE |
| State | WY |
| Zip Code | 82716-2929 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437328663 | Northeast Wyoming Boces | Residential Treatment Facility, Emotionally Disturbed Children | 410 N Miller Ave, Gillette, WY 82716-2929 | 2008-02-21 |
| 1841654860 | Northeast Wyoming Boces | Community/Behavioral Health | 410 N Miller Ave, Gillette, WY 82716-2929 | 2016-04-06 |
| 1427368380 | Krystal Ring | Occupational Therapist | 410 N Miller Ave, Gillette, WY 82716-2929 | 2010-10-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053822387 | Diana Lynn Ohman | Dietitian, Registered | 709 West Eighth Street, Suite 4, Gillette, WY 82716 | 2017-10-13 |
| 1821457821 | Courage To Change Counseling LLC | Community/Behavioral Health | 113 S. Gillette Ave, Gillette, WY 82716 | 2016-02-18 |
| 1003290594 | Kris Huber | Community/Behavioral Health | 905 Gurley Ave, Gillette, WY 82716 | 2015-07-14 |
| 1649516857 | Shirley L Haley | Nurse Practitioner | 1304 West 4th Street, Gillette, WY 82716 | 2012-12-14 |
| 1174867188 | Rebecca J Mader | Registered Nurse | 501 South Burma Ave., Gillette, WY 82716 | 2012-11-15 |
| 1568728228 | Kerry Elizabeth Warner | Registered Nurse | 201 S Burma Ave, Gillette, WY 82716 | 2012-04-07 |
| 1720363351 | Julie Ann Faldalen | Licensed Practical Nurse | 501 South Burma, Gillette, WY 82716 | 2011-10-14 |
| 1083937486 | Clear Creek Counseling LLC | Counselor | 801 E. 4th St., Suite 24, Gillette, WY 82716 | 2010-03-12 |
| 1821241423 | Dianna L Knox | Counselor | 500 S Burma Ave, Gillette, WY 82716 | 2008-10-28 |
| 1588826887 | Scott R Hunter | Chiropractor | 439 Prairie View Place Ste D, Dr S R Hunter, Gillette, WY 82716 | 2008-06-27 |
| Find all providers in zip 82716 | ||||
| Taxonomy Code | 320600000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
| A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental disabilities and/or mental retardation and are not able to live independently. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164894390 | Sharon Schwartz | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1507 Phoenix Ave, Gillette, WY 82716-1936 | 2015-10-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750642526 | Region V Boces | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 3850 N. Wilderness Dr., Wilson, WY 83014 | 2012-06-07 |
Please comment or provide details below to improve the information on NORTHEAST WYOMING BOCES.
| 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.