Caroljean Bongo, PSYD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

432 Issued in WY

Practice address

2909 Bent Ave
Cheyenne, WY 82001-2742

Phone

(307) 760-1871

Fax

(866) 621-1893

NPI assigned

Sep 25, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Dr. Caroljean Bongo Professional name

Medicare fee-for-service enrollment

Enrolled in WY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Caroljean Bongo PSYD LLC

  • Clinical Psychologist
  • Cheyenne, WY
  • NPI 1821297102
  Medicare reassignment Authorized official
• Pathway, Inc.

  • Mental Health Counselor
  • Laramie, WY
  • NPI 1588765069
  NPD (past)

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1134220189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 21270",
            "city": "CHEYENNE",
            "state": "WY",
            "postal_code": "820037025",
            "telephone_number": "307-760-1871",
            "fax_number": "866-621-1893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2909 BENT AVE",
            "city": "CHEYENNE",
            "state": "WY",
            "postal_code": "820012742",
            "telephone_number": "307-760-1871",
            "fax_number": "866-621-1893"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONGO",
        "first_name": "CAROLJEAN",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-25",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WY",
            "license": "432",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "124350100",
            "state": "WY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CAROLJEAN",
            "last_name": "BONGO",
            "prefix": "DR.",
            "credential": "PSYD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Anna Marie Bohl, MSW, PCSW
• Stephanie Rene Boicourt
• Kathy L Bolding, OTD
• Danielle Saydi Bolin
• Tammy Bond
• Meghan Bonner, BCBA
• Courtney Booker, RN
• Ryan M Boone, MD
• Tanya M Borden, LPC
• Rachell Raeann Borges, APRN

• Psychologist in Cheyenne, WY
• Providers in Cheyenne, WY by specialty
• Psychologist in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.