Individual provider Active NPI

Corey Wentz, MS, LPC, LAT

  • Professional Counselor
  • Casper, WY
National Provider Identifier
1528394772
Registry record updated Mar 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LPC 817 Issued in WY
Practice address
1301 S Wisconsin Ave
Casper, WY 82609-2936
Phone
(307) 472-5433
Fax
(307) 337-3705
NPI assigned
Oct 22, 2009
Last updated
Mar 11, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X LAT 286 WY
Professional Counselor 101YP2500X LPC 817 WY Primary

Addresses

Primary practice location

1301 S Wisconsin Ave
Casper, WY 82609-2936

Mailing address

PO Box 552
Casper, WY 82602-0552
Phone (307) 797-4683

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 Science

State licenses

LicenseStateTypeSpecialty
LAT 286WYMDAddiction (Substance Use Disorder) Counselor
LPC 817WYMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Living Well Counseling LLC Addiction (Substance Use Disorder) Past Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1256169600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1457654400000",
    "number": "1528394772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 552",
            "city": "CASPER",
            "state": "WY",
            "postal_code": "826020552",
            "telephone_number": "307-797-4683",
            "fax_number": "307-337-3705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 S WISCONSIN AVE",
            "city": "CASPER",
            "state": "WY",
            "postal_code": "826092936",
            "telephone_number": "307-472-5433",
            "fax_number": "307-337-3705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WENTZ",
        "first_name": "COREY",
        "credential": "MS, LPC, LAT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-10-22",
        "last_updated": "2016-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WY",
            "license": "LAT 286",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WY",
            "license": "LPC 817",
            "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 Mar 11, 2016; 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.