Active NPI
John Cusulos, M.A., LP.C., LAT
- Professional Counselor
- Casper, WY
National Provider Identifier
1053558445
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- LPC-452
- Practice address
- 1430 Wilkins Circle
Casper, WY 82601 - Phone
- (307) 237-9583
- Fax
- (307) 265-7277
- NPI assigned
- Jan 7, 2009
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | LAT-154 | WY | |
| Professional Counselor | 101YP2500X | LPC-452 | WY | Primary |
Addresses
Primary practice location
1430 Wilkins Circle
Casper, WY 82601
Mailing address
1430 Wilkins Circle
Casper, WY 82601
Phone (307) 237-9583
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LAT-154 | WY | MD | Addiction (Substance Use Disorder) Counselor |
| LPC-452 | WY | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1231286400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1231286400000",
"number": "1053558445",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1430 WILKINS CIRCLE",
"city": "CASPER",
"state": "WY",
"postal_code": "82601",
"telephone_number": "307-237-9583",
"fax_number": "307-265-7277"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1430 WILKINS CIRCLE",
"city": "CASPER",
"state": "WY",
"postal_code": "82601",
"telephone_number": "307-237-9583",
"fax_number": "307-265-7277"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CUSULOS",
"first_name": "JOHN",
"credential": "M.A., LP.C., LAT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-01-07",
"last_updated": "2009-01-07",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "WY",
"license": "LAT-154",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "WY",
"license": "LPC-452",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Casper, WY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.