| Wandering Minds Llc | |
|
2321 Dunn Ave Cheyenne WY 82001-3214 | |
| (307) 996-7320 | |
| Not Available |
| Full Name | Wandering Minds Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 2321 Dunn Ave, Cheyenne, Wyoming |
| Authorized Official Name and Position | Monica Baker (OWNER) |
| Authorized Official Contact | 3079967320 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wandering Minds Llc Po Box 2072 Cheyenne WY 82003-2072 Ph: () - | Wandering Minds Llc 2321 Dunn Ave Cheyenne WY 82001-3214 Ph: (307) 996-7320 |
| NPI Number | 1497439459 |
|---|---|
| Provider Enumeration Date | 06/12/2023 |
| Last Update Date | 06/12/2023 |
| Certification Date | 06/11/2023 |
| Medicare PECOS PAC ID | 8921468109 |
|---|---|
| Medicare Enrollment ID | O20230719002988 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497439459 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
| Provider Name | Monica Baker |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1164040101 PECOS PAC ID: 7810374006 Enrollment ID: I20220509001208 |
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