| Aspen Counseling Services Llc | |
|
702 Platinum Ave Cody WY 82414-3423 | |
| (307) 213-9954 | |
| (307) 275-9843 |
| Full Name | Aspen Counseling Services Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 702 Platinum Ave, Cody, Wyoming |
| Authorized Official Name and Position | Demetria Bales (OWNER) |
| Authorized Official Contact | 3072139954 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Aspen Counseling Services Llc 6 Road 6pr Cody WY 82414-5700 Ph: (541) 404-4900 | Aspen Counseling Services Llc 702 Platinum Ave Cody WY 82414-3423 Ph: (307) 213-9954 |
| NPI Number | 1528723004 |
|---|---|
| Provider Enumeration Date | 11/01/2021 |
| Last Update Date | 08/01/2022 |
| Certification Date | 08/01/2022 |
| Medicare PECOS PAC ID | 9133517873 |
|---|---|
| Medicare Enrollment ID | O20211028002052 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528723004 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Demetria Bales |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1144613134 PECOS PAC ID: 9638577836 Enrollment ID: I20211027003091 |
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