Rickie L Labounta, CAP
Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Douglas, WY
NPI 1609361997 · NPPES record last updated Jan 31, 2019
Key facts
- NPI
- 1609361997
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Addiction (Substance Use Disorder) Counselor 101YA0400X
- License
- CAP-174 (WY)
- Practice address
- 1841 Madora Ave
Douglas, WY 82633-3057 - Phone
- (307) 358-2846
- Fax
- (307) 358-1144
- NPI assigned
- Jun 28, 2018
- 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
| License | State | Type | Specialty |
|---|---|---|---|
| CAP-174 | WY | MD | Addiction (Substance Use Disorder) Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | WY | ||
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | CAP-174 | WY | Yes |
Addresses
Primary practice location
1841 Madora Ave
Douglas, WY 82633-3057
Mailing address
1841 Madora Ave
Douglas, WY 82633-3057
Phone (307) 358-2846
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 106402908 | Medicaid | WY | |
| 106402907 | Medicaid | WY |
Other providers in Douglas, WY
- Shauna R Kohler
- W Scott Kreycik
- Thomas F Kroenke
- Lance Krunosky
- Callie Americus Kunz
- Laramie Peak Therapies, LLC
- Elijah Lee
- Shea Lehnen
- Cherie Lehner
- Steve M Lewis
All providers in Douglas, WY · Addiction (Substance Use Disorder) Counselor in Wyoming
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 31, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.