NPIMap

Organization Active NPI

High Country Behavioral Health

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Evanston, WY
National Provider Identifier
1891099545
Registry record updated Nov 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
License
LPC-550 Issued in 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
Last updated
Nov 3, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2025

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

Authorized official

Name
Mr. Kipp L Dana, LPC, LATNPI 1386825446
Title
Executive Director
Phone
(307) 885-9883

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Addiction Medicine (Family Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207QA0401X
Community/Behavioral Health Agency 251S00000X WY
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X LPC-550 WY Primary
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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WY

Enrollment records 1

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…

Other NPIs on the same Medicare enrollment 23

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

View all 23

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
53D2260176High Country Behavioral Health190 Overthrust Rd, Evanston, WY 82930Certificate of waiverMay 15, 2028

National Provider Directory

National Provider Directory
Tax ID family
High Country Behavioral Health27 organizations share this tax ID, including this one

Other organizations with this tax ID 26

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

View all 26

Locations

190 Overthrust Rd
Ste 105
Evanston, WY 82930

75 Yellow Creek Rd
Ste 105
Evanston, WY 82930

Practitioners & affiliated clinicians

Practitioners 29

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.

View all 29

NPI Registry JSON

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

{
    "created_epoch": "1294617600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1762128000000",
    "number": "1891099545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2910",
            "city": "EVANSTON",
            "state": "WY",
            "postal_code": "829312910",
            "telephone_number": "307-789-4224",
            "fax_number": "307-789-4225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "190 OVERTHRUST RD",
            "address_2": "STE 105",
            "city": "EVANSTON",
            "state": "WY",
            "postal_code": "829305205",
            "telephone_number": "307-789-4224",
            "fax_number": "307-789-4225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HIGH COUNTRY BEHAVIORAL HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-10",
        "last_updated": "2025-11-03",
        "certification_date": "2025-11-03",
        "status": "A",
        "authorized_official_last_name": "DANA",
        "authorized_official_first_name": "KIPP",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "307-885-9883",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LPC, LAT"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207QA0401X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Addiction Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "WY",
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "WY",
            "license": "LPC-550",
            "primary": true
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "WY",
            "license": "LAT-220",
            "primary": false
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evanston, WY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.