| Specialty Counseling & Consulting | |
|
4025 Rawlins St Cheyenne WY 82001-1900 | |
| (307) 426-4798 | |
| (307) 426-4798 |
| Full Name | Specialty Counseling & Consulting |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 4025 Rawlins St, Cheyenne, Wyoming |
| Authorized Official Name and Position | Robert Logan (OWNER/OPERATOR) |
| Authorized Official Contact | 3074264798 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Specialty Counseling & Consulting 4025 Rawlins St Cheyenne WY 82001-1900 Ph: (307) 426-4798 | Specialty Counseling & Consulting 4025 Rawlins St Cheyenne WY 82001-1900 Ph: (307) 426-4798 |
| NPI Number | 1538462783 |
|---|---|
| Provider Enumeration Date | 12/09/2010 |
| Last Update Date | 10/27/2023 |
| Certification Date | 10/27/2023 |
| Medicare PECOS PAC ID | 8921311911 |
|---|---|
| Medicare Enrollment ID | O20150720002981 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538462783 | NPI | - | NPPES |
| 130259100 | Medicaid | WY | |
| 9000142271 | Medicaid | CO |
| Provider Name | Denise Mcclellan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851732549 PECOS PAC ID: 1557593233 Enrollment ID: I20190725003180 |
| Provider Name | Raul A Padilla |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932481124 PECOS PAC ID: 6608043518 Enrollment ID: I20191001001863 |
| Provider Name | Tara Monique Rios Vega |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1710406319 PECOS PAC ID: 3971938879 Enrollment ID: I20200211001538 |
| Provider Name | Sandra J Brausch |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1932282837 PECOS PAC ID: 4385056399 Enrollment ID: I20201216001761 |
| Provider Name | Randi Losalu |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1598243156 PECOS PAC ID: 3072920628 Enrollment ID: I20210325002095 |
| Provider Name | Amy Mavy |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1942490792 PECOS PAC ID: 8820405921 Enrollment ID: I20210407000663 |
| Provider Name | Megan Bowman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1427460237 PECOS PAC ID: 2769870112 Enrollment ID: I20211104001188 |
| Provider Name | Brooke Jostad |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1578939864 PECOS PAC ID: 2264764521 Enrollment ID: I20220429000512 |
| Provider Name | Rachel Taylor |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1326703489 PECOS PAC ID: 1456705433 Enrollment ID: I20230925002009 |
| Provider Name | Clay William Dokken |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1154626711 PECOS PAC ID: 7214385996 Enrollment ID: I20231120001666 |
| Provider Name | Daniel A Bort |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1114148020 PECOS PAC ID: 6800244500 Enrollment ID: I20231120002557 |
| Provider Name | Randall Alan Basden |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1831311760 PECOS PAC ID: 3375991714 Enrollment ID: I20231127001120 |
| Provider Name | Tracey Harris |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1639843345 PECOS PAC ID: 7315396157 Enrollment ID: I20231206000233 |
| Provider Name | Jonna Langston |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1750635678 PECOS PAC ID: 5092163907 Enrollment ID: I20240103003961 |
| Provider Name | Beatriz Carolina Grullon |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1811403371 PECOS PAC ID: 6709234206 Enrollment ID: I20240104003969 |
| Provider Name | Kalyn K Krotz |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1316106503 PECOS PAC ID: 3173974813 Enrollment ID: I20240108003567 |
| Provider Name | Gary R King |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1346405016 PECOS PAC ID: 0446601199 Enrollment ID: I20240108003912 |
| Provider Name | Eric Z Williams |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1043816960 PECOS PAC ID: 2961853445 Enrollment ID: I20240109002892 |
| Provider Name | Robert A Logan |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1134342199 PECOS PAC ID: 3375856362 Enrollment ID: I20240110003716 |
| Provider Name | Dawn Marie Marchak |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1578836805 PECOS PAC ID: 6800244302 Enrollment ID: I20240110005250 |
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Gloria D Rutt Psyd Pc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2305 Coulter Drive, Cheyenne, WY 82009 Phone: 307-286-4106 Fax: 307-632-6588 | |
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