Clear Creek Counseling LLC

Primary specialty

CounselorTaxonomy code 101Y00000X

License

LPC-372 Issued in WY

Legal business name

CLEAR CREEK COUNSELING LLC

Practice address

801 E. 4TH St.
Suite 24
Gillette, WY 82716

Phone

(307) 686-9422

Fax

(307) 686-3833

NPI assigned

Mar 12, 2010

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dale F. Oedekoven, MA, LPC, LAT, NCC

Title

Co-Owner

Phone

(307) 686-9422

Specialties & licenses 3

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1268352000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1271808000000",
    "number": "1083937486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 E. 4TH ST.",
            "address_2": "SUITE 24",
            "city": "GILLETTE",
            "state": "WY",
            "postal_code": "82716",
            "telephone_number": "307-686-9422",
            "fax_number": "307-686-3833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 E. 4TH ST.",
            "address_2": "SUITE 24",
            "city": "GILLETTE",
            "state": "WY",
            "postal_code": "82716",
            "telephone_number": "307-686-9422",
            "fax_number": "307-686-3833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLEAR CREEK COUNSELING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-12",
        "last_updated": "2010-04-21",
        "status": "A",
        "authorized_official_last_name": "OEDEKOVEN",
        "authorized_official_first_name": "DALE",
        "authorized_official_middle_name": "F.",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "307-686-9422",
        "authorized_official_credential": "MA, LPC, LAT, NCC"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor",
            "state": "WY",
            "license": "LPC540",
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor",
            "state": "WY",
            "license": "LPC-372",
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "WY",
            "license": "540",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Counselor in Gillette, WY
• Providers in Gillette, WY by specialty
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.