| Mindfully Reconnect | |
|
2321 Dunn Ave Cheyenne WY 82001-3214 | |
| (307) 640-1008 | |
| Not Available |
| Full Name | Mindfully Reconnect |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 2321 Dunn Ave, Cheyenne, Wyoming |
| Authorized Official Name and Position | Elizabeth Ann Schroll (ONWER) |
| Authorized Official Contact | 3076401008 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mindfully Reconnect 2321 Dunn Ave Cheyenne WY 82001-3214 Ph: (307) 640-1008 | Mindfully Reconnect 2321 Dunn Ave Cheyenne WY 82001-3214 Ph: (307) 640-1008 |
| NPI Number | 1003234774 |
|---|---|
| Provider Enumeration Date | 03/31/2014 |
| Last Update Date | 06/19/2025 |
| Certification Date | 06/19/2025 |
| Medicare PECOS PAC ID | 8921231275 |
|---|---|
| Medicare Enrollment ID | O20140512001826 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003234774 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | LCSW 731 (Wyoming) | Primary |
| Provider Name | Elizabeth A Pollnow |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1124353842 PECOS PAC ID: 3375728777 Enrollment ID: I20110428000716 |
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