Cory Dean Carpenter, PCSW, CAP

Individual provider Active NPI Clinical Social Worker · Powell, WY

NPI 1669740858 · NPPES record last updated Jun 5, 2019

Key facts

NPI
1669740858
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
PCSW-843 (WY)
Practice address
306 N Bent St
Powell, WY 82435-2338
Phone
(307) 202-1067
NPI assigned
Dec 2, 2011
Sex
Male
Sole proprietor
No

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 and National Provider Directory roles.

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
PCSW-843WYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Northwest Wyoming Treatment Center Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 152 WY
Clinical Social Worker 1041C0700X PCSW-843 WY Yes

Addresses

Primary practice location

306 N Bent St
Powell, WY 82435-2338

Mailing address

555 Mountain View St
Powell, WY 82435-1720
Phone (307) 202-1067

Other practice location 1

1106 Julie Ln
Powell, WY 82435-1632
Phone (307) 271-7460

Other providers in Powell, WY

All providers in Powell, WY · Clinical Social Worker in Wyoming

Sources for this page

Verify at the official NPI Registry.