Mourning Glory Counseling LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

456 Issued in WY

Legal business name

MOURNING GLORY COUNSELING LLC

Practice address

1300 E a St Ste 201
Casper, WY 82601-2252

Phone

(307) 235-3333

Fax

(307) 266-5155

NPI assigned

Dec 5, 2016

Organization subpart

No

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

Authorized official

Name

Mrs. Tisa M Sucher, LCSW

Title

Licensed Clinical Social Worker

Phone

(307) 235-3333

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1480896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1480896000000",
    "number": "1902340326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 E A ST STE 201",
            "city": "CASPER",
            "state": "WY",
            "postal_code": "826012252",
            "telephone_number": "307-235-3333",
            "fax_number": "307-266-5155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 E A ST STE 201",
            "city": "CASPER",
            "state": "WY",
            "postal_code": "826012252",
            "telephone_number": "307-235-3333",
            "fax_number": "307-266-5155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOURNING GLORY COUNSELING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-12-05",
        "last_updated": "2016-12-05",
        "status": "A",
        "authorized_official_last_name": "SUCHER",
        "authorized_official_first_name": "TISA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "LICENSED CLINICAL SOCIAL WORKER",
        "authorized_official_telephone_number": "307-235-3333",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "WY",
            "license": "456",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Casper, WY
• Providers in Casper, WY by specialty
• Clinical Social Worker in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.