| Charles Joseph Cordova, LPC | |
|
730 Montana Ave, Lovell, WY 82431-1810 | |
| (307) 272-8798 | |
| Not Available |
| Full Name | Charles Joseph Cordova |
|---|---|
| Gender | Male |
| Speciality | Counselor - Professional |
| Location | 730 Montana Ave, Lovell, Wyoming |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073978920 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | LPC-1534 (Wyoming) | Primary |
| Entity Name | Eagle Rock Counseling Services Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1699537894 PECOS PAC ID: 9234574245 Enrollment ID: O20240229002576 |
| Mailing Address | Practice Location Address |
|---|---|
| Charles Joseph Cordova, LPC 730 Montana Ave, Lovell, WY 82431-1810 Ph: () - | Charles Joseph Cordova, LPC 730 Montana Ave, Lovell, WY 82431-1810 Ph: (307) 272-8798 |
Mr. Lucas Grant, MS, LPC, NCC Counselor Medicare: Not Enrolled in Medicare Practice Location: 317 Nevada Ave, Lovell, WY 82431 Phone: 307-254-9111 | |
Kathryn Glen Winterholler, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 67 Quebec Ave, Lovell, WY 82431 Phone: 307-431-2080 | |
Gerry Ryan Burton, MS, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 59 E Main St, Lovell, WY 82431 Phone: 307-272-4972 | |
Mrs. Theresa Woodward, LPC, NCC Counselor Medicare: Not Enrolled in Medicare Practice Location: 440 Nevada Ave, Lovell, WY 82431 Phone: 307-399-9134 | |
Mrs. Dey Lynn Stebner, M.S. COUNSELING Counselor Medicare: Medicare Enrolled Practice Location: 1114 Lane 12, Lovell, WY 82431 Phone: 307-548-6543 Fax: 307-548-6565 | |
Ms. Dorthy Baker Kister, MSW Counselor Medicare: Medicare Enrolled Practice Location: 1114 Lane 12, Lovell, WY 82431 Phone: 307-548-6543 Fax: 307-548-6565 |