Devin E Dutson, LCSW

Individual provider Active NPI Clinical Social Worker · Powell, WY

NPI 1710159595 · NPPES record last updated Oct 30, 2014

Key facts

NPI
1710159595
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
LCSW-629 (WY)
Practice address
1061 Morning Glory LN
Powell, WY 82435-2266
Phone
(307) 254-3407
NPI assigned
Apr 1, 2008
Sex
Male
Sole proprietor
Yes

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
LCSW-629WYMDClinical Social Worker

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LCSW-629 WY Yes

Addresses

Primary practice location

1061 Morning Glory LN
Powell, WY 82435-2266

Mailing address

1061 Morning Glory LN
Powell, WY 82435-2266
Phone (307) 254-3407

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.