Organization Active NPI

Outside Therapy LLC

  • Professional Counselor
  • Cheyenne, WY
National Provider Identifier
1902652274
Registry record updated Apr 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Legal business name
OUTSIDE THERAPY LLC
Practice address
1918 Thomes Ave
Cheyenne, WY 82001-3527
Phone
(307) 313-2777
NPI assigned
Apr 27, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2025

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

Authorized official

Name
Alyse Pfankuch, MA LPCNPI 1962167098
Title
Therapist
Phone
(307) 221-0317

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YP2500X Primary

Addresses

Primary practice location

1918 Thomes Ave
Cheyenne, WY 82001-3527

Mailing address

4726 Mountain Rd Apt 520
Cheyenne, WY 82009-5157
Phone (307) 221-0317

Other practice location 1

1050 N 3rd St Ste K
Laramie, WY 82072-2543
Phone (307) 221-0317

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240916003242 WY Part B Supplier - Clinic/Group Practice 8628519899 Receives reassigned benefits from 1 practitioner
Practice locations: Cheyenne, WY

National Provider Directory

National Provider Directory

Locations

1520 Logan Ave
Cheyenne, WY 82001
Phone (970) 225-1581

1918 Thomes Ave
Cheyenne, WY 82001
Phone (307) 221-0317

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1714176000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1743811200000",
    "number": "1902652274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4726 MOUNTAIN RD APT 520",
            "city": "CHEYENNE",
            "state": "WY",
            "postal_code": "820095157",
            "telephone_number": "307-221-0317"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1918 THOMES AVE",
            "city": "CHEYENNE",
            "state": "WY",
            "postal_code": "820013527",
            "telephone_number": "307-313-2777"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1050 N 3rd St Ste K",
            "address_purpose": "LOCATION",
            "city": "Laramie",
            "state": "WY",
            "postal_code": "820722543",
            "country_code": "US",
            "telephone_number": "307-221-0317",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "OUTSIDE THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-27",
        "last_updated": "2025-04-05",
        "certification_date": "2025-04-05",
        "status": "A",
        "authorized_official_last_name": "PFANKUCH",
        "authorized_official_first_name": "ALYSE",
        "authorized_official_title_or_position": "THERAPIST",
        "authorized_official_telephone_number": "307-221-0317",
        "authorized_official_credential": "MA LPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cheyenne, WY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2025; 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.