| Tina Dall States, LPC | |
|
450 Mountain View, Building C, Powell, WY 82435-1958 | |
| (307) 254-0661 | |
| Not Available |
| Full Name | Tina Dall States |
|---|---|
| Gender | Female |
| Speciality | Counselor - Mental Health |
| Location | 450 Mountain View, Powell, Wyoming |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952315046 | NPI | - | NPPES |
| 314239 | Other | WY | BCBS/WY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | LPC 926 (Wyoming) | Primary |
| Entity Name | Bozeman Health Deaconess Hospital |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1619347390 PECOS PAC ID: 4688984164 Enrollment ID: O20151112002559 |
| Mailing Address | Practice Location Address |
|---|---|
| Tina Dall States, LPC 652 Cedarwood Dr, Powell, WY 82435-1743 Ph: (307) 254-0661 | Tina Dall States, LPC 450 Mountain View, Building C, Powell, WY 82435-1958 Ph: (307) 254-0661 |
Melissa Ginest, LCPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 130 N Bent St Ste B, Powell, WY 82435 Phone: 077-644-1073 Fax: 307-764-1879 | |
Shane Roberts, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1054 Vali Rd, Powell, WY 82435 Phone: 307-254-8129 | |
Jessica Williams, LPC Counselor Medicare: Medicare Enrolled Practice Location: 1106 Julie Ln, Powell, WY 82435 Phone: 307-271-7460 | |
Gregory James Bennett, LAT Counselor Medicare: Not Enrolled in Medicare Practice Location: 249 E 2nd St Ste 1, Powell, WY 82435 Phone: 307-254-2038 | |
Jessica Rapp, Counselor Medicare: Not Enrolled in Medicare Practice Location: 687 Avenue J, Powell, WY 82435 Phone: 253-820-5278 | |
Mrs. Lisa Jane Eaton, MS OTR/L CAP Counselor Medicare: Not Enrolled in Medicare Practice Location: 507 N Clark St, Powell, WY 82435 Phone: 970-420-9588 | |
Ms. Diana Lynne Whitney, MS, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 375 Lane 7 1/2, Powell, WY 82435 Phone: 307-884-8872 |