MRS. CASSIDY DIANE PROVO (NPI# 1942851019) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942851019 |
| Entity Type | Individual |
| Full Name | MRS. CASSIDY DIANE PROVO |
| Other Name | MISS CASSIDY DIANE BENSON |
| Credential | PPC |
| Practice Address |
2241 Farnum St Ste 102 Casper WY 82609-4108 |
| Practice Telephone | 3072349979 |
| Practice Fax Number | 3072349989 |
| Mailing Telephone | 3072349979 |
| Mailing Fax Number | 3072349989 |
| Enumeration Date | 2019-09-20 |
| Last Update Date | 2019-09-20 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YP2500X |
Counselor Specialization: Professional |
1151 | WY | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WY | 1295286185 | 05 |
| Street Address |
2241 FARNUM ST STE 102 |
| City | CASPER |
| State | WY |
| Zip Code | 82609-4108 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265047773 | Backcountry Dox, LLC | Family Medicine | 1320 Morado Dr, Casper, WY 82609 | 2020-09-11 |
| 1174158273 | Harmony Case Management LLC | Case Management | 219 S Sinclair Pl, Casper, WY 82609 | 2020-03-09 |
| 1427417815 | Haley Perl | Speech-Language Pathologist | 2510 E 15th St Ste 15, Casper, WY 82609 | 2016-02-15 |
| 1538550496 | Andrea Renee Swanson | Counselor | 2015 E. 15th St., Suite 10, Casper, WY 82609 | 2015-02-13 |
| 1619386901 | Kmart Pharmacy | Pharmacy | 4000 East 2nd, Casper, WY 82609 | 2014-08-12 |
| 1306268628 | Kati Jo Tuma | Physician Assistant | 6600 E. 2nd Street, Casper, WY 82609 | 2014-01-07 |
| 1609297506 | Summit Medical Center, LLC | General Acute Care Hospital | 6350 E. 2nd Street, Casper, WY 82609 | 2013-12-18 |
| 1013354158 | Phillip Hermon | Registered Nurse | 2515 East 8th St, Casper, WY 82609 | 2013-05-30 |
| 1992141527 | Wind City Dental | Dentist | 1530 Centennial Court, Casper, WY 82609 | 2013-05-22 |
| 1235404930 | Melanie Anne Connell | Counselor | 2955 E. 2nd St., Casper, WY 82609 | 2012-03-13 |
| Find all providers in zip 82609 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053920280 | Christopher Aaron Poe | Counselor | 1030 N Poplar St Ste B, Casper, WY 82601-1378 | 2020-07-23 |
| 1336690643 | Leigh Yaughn | Counselor | 76 Dahlia St, Casper, WY 82604-4054 | 2016-10-21 |
| 1649645466 | Brooke N White | Counselor | 933 W 14th St Ste 1, Casper, WY 82601-3561 | 2015-12-04 |
| 1538550496 | Andrea Renee Swanson | Counselor | 2015 E. 15th St., Suite 10, Casper, WY 82609 | 2015-02-13 |
| 1952706822 | Sweetwater Counseling | Counselor | 3211 Energy Ln Ste 402, Casper, WY 82604-2963 | 2014-11-04 |
| 1992109441 | Christy Lee Jindrick Tholl | Counselor | 4155 Legion Ln Ste 3, Casper, WY 82609-1945 | 2014-10-13 |
| 1851722482 | Kelsey L Mammen | Counselor | 580 Granite Peak Dr Apt 207, Casper, WY 82609-4529 | 2013-12-08 |
| 1538456231 | Robert Paul Maddox II | Counselor | 123 W 1st St Ste 208b, Casper, WY 82601-2480 | 2011-07-01 |
| 1710279302 | Linda Christine Butts | Counselor | 411 S Walsh Dr, Suite 135a, Casper, WY 82609-2306 | 2011-05-14 |
| 1508096223 | Katharine A Schneider | Counselor | 400 E 1st St # 219, Casper, WY 82601 | 2009-07-15 |
| Find all providers in CASPER | ||||
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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.