Reyes Pacheco, PCSW
Individual provider Active NPI Mental Health Clinic/Center (Including Community Mental Health Center) · Casper, WY
NPI 1891558029 · NPPES record last updated Jan 31, 2024
Key facts
- NPI
- 1891558029
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
- License
- PCSW (WY)
- Practice address
- 1514 E 12TH St Unit 201
Casper, WY 82601-4080 - Phone
- (307) 258-1226
- NPI assigned
- Jan 31, 2024
- 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
| License | State | Type | Specialty |
|---|---|---|---|
| PCSW | WY | MD | Mental Health Clinic/Center (Including Community Mental Health Center) |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Clinic/Center (Including Community Mental Health Center) | 261QM0801X | PCSW | WY | Yes |
Addresses
Primary practice location
1514 E 12TH St Unit 201
Casper, WY 82601-4080
Mailing address
1221 Ivy LN
Casper, WY 82609-3065
Phone (307) 258-1226
Other practice location 1
1221 Ivy Ln
Casper, WY 82609-3065
Phone (307) 258-1226
Other names
- Ray Pacheco
Other providers in Casper, WY
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- Maliha D Owens
- Sierra Oxford
- Rita Padilla
- Tamara Kaye Page
- Michael Anthony Paglia
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- Bradley J Palmer
All providers in Casper, WY · Mental Health Clinic/Center (Including Community Mental Health Center) in Wyoming
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 31, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.