High Country Behavioral Health

Organization Active NPI Mental Health Clinic/Center (Including Community Mental Health Center) · Evanston, WY

NPI 1891099545 · NPPES record last updated Nov 3, 2025

Key facts

NPI
1891099545
Entity type
Organization (NPI type 2)
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
License
LPC-550 (WY)
Legal business name
HIGH COUNTRY BEHAVIORAL HEALTH
Practice address
190 Overthrust Rd
Ste 105
Evanston, WY 82930-5205
Phone
(307) 789-4224
Fax
(307) 789-4225
NPI assigned
Jan 10, 2011
Organization subpart
No

Authorized official

Name
Mr. Kipp L Dana, LPC, LAT
Title
Executive Director
Phone
(307) 885-9883

Other NPIs on the same Medicare enrollment 23

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Corporate family (same tax ID) 26

Organizations that report the same tax identification number in the National Provider Directory.

View all 26

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
53D2260176High Country Behavioral Health
190 Overthrust Rd, Evanston, WY 82930
Certificate of waiverMay 15, 2028

Medicare participation

Medicare fee-for-service enrollment
Enrolled in WY

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20110418000512 WY Part B Supplier - Clinic/Group Practice 0648454587 Receives reassigned benefits from 52 practitioners
23 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Glenrock, WY; Thermopolis, WY; Thayne, WY; Rawlins, WY; Pinedale, WY; Lyman, WY; Kemmerer, WY; Afton, WY…

National Provider Directory

Tax ID family
High Country Behavioral Health (27 organizations share this tax ID)

Locations

190 Overthrust Rd
Ste 105
Evanston, WY 82930

75 Yellow Creek Rd
Ste 105
Evanston, WY 82930

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP
207Q00000X
Addiction Medicine (Family Medicine) Physician
Group: 193200000X MULTI-SPECIALTY GROUP
207QA0401X
Community/Behavioral Health Agency 251S00000X WY
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X LPC-550 WY Yes
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X LAT-220 WY
Clinical Medical Laboratory 291U00000X

Addresses

Primary practice location

190 Overthrust Rd
Ste 105
Evanston, WY 82930-5205

Mailing address

PO Box 2910
Evanston, WY 82931-2910
Phone (307) 789-4224

Other identifiers

IdentifierTypeStateIssuer
117847400MedicaidWY

Other providers in Evanston, WY

All providers in Evanston, WY · Mental Health Clinic/Center (Including Community Mental Health Center) in Wyoming

Sources for this page

Verify at the official NPI Registry.