Kevin James Parker

Individual provider Active NPI Professional Counselor · Sheridan, WY

NPI 1508339649 · NPPES record last updated Nov 2, 2020

Key facts

NPI
1508339649
Entity type
Individual (NPI type 1)
Primary specialty
Professional Counselor 101YP2500X
License
LPC-1903 (WY)
Practice address
1221 W 5TH St
Sheridan, WY 82801-2701
Phone
(307) 674-4405
NPI assigned
Jan 10, 2019
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
LPC-1903WYMDProfessional Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X LPC-1903 WY Yes

Addresses

Primary practice location

1221 W 5TH St
Sheridan, WY 82801-2701

Mailing address

1221 W 5TH St
Sheridan, WY 82801-2701
Phone (307) 674-4405

Other providers in Sheridan, WY

All providers in Sheridan, WY · Professional Counselor in Wyoming

Sources for this page

Verify at the official NPI Registry.