| Meadowlark Counseling | |
|
201 W Lakeway Rd Ste 400 Gillette WY 82718-6307 | |
| (307) 686-0808 | |
| (888) 491-5505 |
| Full Name | Meadowlark Counseling |
|---|---|
| Speciality | Psychologist |
| Location | 201 W Lakeway Rd Ste 400, Gillette, Wyoming |
| Authorized Official Name and Position | Barbara L Daley (OWNER) |
| Authorized Official Contact | 3076860808 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Meadowlark Counseling 201 W Lakeway Rd Ste 400 Gillette WY 82718-6307 Ph: (307) 686-0808 | Meadowlark Counseling 201 W Lakeway Rd Ste 400 Gillette WY 82718-6307 Ph: (307) 686-0808 |
| NPI Number | 1477943462 |
|---|---|
| Provider Enumeration Date | 01/28/2015 |
| Last Update Date | 12/14/2020 |
| Certification Date | 12/14/2020 |
| Medicare PECOS PAC ID | 5698087062 |
|---|---|
| Medicare Enrollment ID | O20150629001199 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477943462 | NPI | - | NPPES |
| 138736700 | Medicaid | WY | |
| 60229551 | Medicaid | CO | |
| COAAA0791 | Other | CO | MEDICARE INDIVIDUAL |
| 139588200 | Medicaid | WY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
| 103T00000X | Psychologist | 545 (Wyoming) | Primary |
| 103T00000X | Psychologist | (* (Not Available)) | Secondary |
| Provider Name | Barbara Lynne St Clair |
|---|---|
| Provider Type | Practitioner - Psychologist Billing Independently |
| Provider Identifiers | NPI Number: 1255623682 PECOS PAC ID: 3173701745 Enrollment ID: I20150720001994 |
| Provider Name | Brenda J Engle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639375678 PECOS PAC ID: 8224121637 Enrollment ID: I20170320001418 |
| Provider Name | Sarah Anne Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871987826 PECOS PAC ID: 6002172608 Enrollment ID: I20171115001734 |
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