Caroljean Bongo PSYD LLC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

432 Issued in WY

Legal business name

CAROLJEAN BONGO PSYD LLC

Practice address

2909 Bent Ave
Cheyenne, WY 82001-2742

Phone

(307) 760-1871

Fax

(866) 621-1893

NPI assigned

Jul 16, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Caroljean Bongo, PSYDNPI 1134220189

Title

Clinical Psychologist

Phone

(307) 760-1871

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WY

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Caroljean Bongo, PSYD

  • Psychologist
  • Cheyenne, WY
  • NPI 1134220189
  Medicare reassignment Authorized official
• Jodi L Bills, LPC, LAT, BCB-HRV

  • Professional Counselor
  • Cheyenne, WY
  • NPI 1194824623
  NPD (past)

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

{
    "created_epoch": "1184544000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1821297102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 21270",
            "city": "CHEYENNE",
            "state": "WY",
            "postal_code": "820037025",
            "telephone_number": "307-760-1871",
            "fax_number": "866-621-1893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2909 BENT AVE",
            "city": "CHEYENNE",
            "state": "WY",
            "postal_code": "820012742",
            "telephone_number": "307-760-1871",
            "fax_number": "866-621-1893"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROLJEAN BONGO PSYD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-16",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "BONGO",
        "authorized_official_first_name": "CAROLJEAN",
        "authorized_official_title_or_position": "CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "307-760-1871",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "WY",
            "license": "432",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "124350100",
            "state": "WY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jeffrey C Carlton, M.D.
• Carmel Community Living Corporation (Overture)
• Rebecca Kay Carney Calisch, M.D.
• Carol a Fischer MD PC
• Carol J. Erickson, PSYD., P.C. (CE Mental Health Services)
• Leif Carpenter
• Carol Elizabeth Carr
• Ashley Carrick, PTA
• Amber Carroll, DPT
• Christy Carroll

• Clinical Psychologist in Cheyenne, WY
• Providers in Cheyenne, WY by specialty
• Clinical Psychologist in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.