Active NPI
Thomas Huddleston
- Mental Health Counselor
- Evanston, WY
National Provider Identifier
1295977213
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- LPC-629
- Practice address
- 350 City View Dr
Ste 302
Evanston, WY 82930-5327 - Phone
- (307) 789-7915
- Fax
- (307) 789-6009
- NPI assigned
- Apr 6, 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | LPC-629 | WY | Primary |
Addresses
Primary practice location
350 City View Dr
Ste 302
Evanston, WY 82930-5327
Mailing address
350 City View Dr
Ste 302
Evanston, WY 82930-5327
Phone (307) 789-7915
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LPC-629 | WY | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1238976000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1238976000000",
"number": "1295977213",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "350 CITY VIEW DR",
"address_2": "STE 302",
"city": "EVANSTON",
"state": "WY",
"postal_code": "829305327",
"telephone_number": "307-789-7915",
"fax_number": "307-789-6009"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "350 CITY VIEW DR",
"address_2": "STE 302",
"city": "EVANSTON",
"state": "WY",
"postal_code": "829305327",
"telephone_number": "307-789-7915",
"fax_number": "307-789-6009"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HUDDLESTON",
"first_name": "THOMAS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-04-06",
"last_updated": "2009-04-06",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "WY",
"license": "LPC-629",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Evanston, WY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 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.