| Healing Tree Counseling Llc | |
|
135 W 9th St Casper WY 82601-3722 | |
| (307) 215-1204 | |
| (307) 215-1204 |
| Full Name | Healing Tree Counseling Llc |
|---|---|
| Speciality | Counselor |
| Location | 135 W 9th St, Casper, Wyoming |
| Authorized Official Name and Position | Jennifer Susan Cruickshank (OWNER) |
| Authorized Official Contact | 3072151204 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Healing Tree Counseling Llc 135 W 9th St Casper WY 82601-3722 Ph: (307) 215-1204 | Healing Tree Counseling Llc 135 W 9th St Casper WY 82601-3722 Ph: (307) 215-1204 |
| NPI Number | 1245786110 |
|---|---|
| Provider Enumeration Date | 08/30/2016 |
| Last Update Date | 03/23/2021 |
| Certification Date | 03/23/2021 |
| Medicare PECOS PAC ID | 5294179073 |
|---|---|
| Medicare Enrollment ID | O20240220003346 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245786110 | NPI | - | NPPES |
| 144332100 | Medicaid | WY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | LPC-1625 (Wyoming) | Primary |
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
| Provider Name | Jennifer Susan Cruickshank |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1295194934 PECOS PAC ID: 1557705332 Enrollment ID: I20240220003397 |
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