NPIMap

Organization Active NPI

Complete Care Counseling, LLC

  • Clinical Social Worker
  • Casper, WY
National Provider Identifier
1972854800
Registry record updated Oct 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW 800 Issued in WY
Legal business name
COMPLETE CARE COUNSELING, LLC
Practice address
2510 E 15TH St
Suite 11
Casper, WY 82609-4111
Phone
(307) 234-9979
Fax
(307) 234-9989
NPI assigned
Oct 2, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2012

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

Authorized official

Name
Ms. Codie Lynn Wallace, LCSW
Title
Owner
Phone
(307) 797-1726

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X LCSW 800 WY Primary

Addresses

Primary practice location

2510 E 15TH St
Suite 11
Casper, WY 82609-4111

Mailing address

2510 E 15TH St
Suite 11
Casper, WY 82609-4111
Phone (307) 234-9979

National Provider Directory

National Provider Directory

Locations

2510 E 15th St
Ste 11
Casper, WY 82609
Phone (307) 234-9979

NPI Registry JSON

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

{
    "created_epoch": "1349136000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1349136000000",
    "number": "1972854800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2510 E 15TH ST",
            "address_2": "SUITE 11",
            "city": "CASPER",
            "state": "WY",
            "postal_code": "826094111",
            "telephone_number": "307-234-9979",
            "fax_number": "307-234-9989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2510 E 15TH ST",
            "address_2": "SUITE 11",
            "city": "CASPER",
            "state": "WY",
            "postal_code": "826094111",
            "telephone_number": "307-234-9979",
            "fax_number": "307-234-9989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMPLETE CARE COUNSELING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-02",
        "last_updated": "2012-10-02",
        "status": "A",
        "authorized_official_last_name": "WALLACE",
        "authorized_official_first_name": "CODIE",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "307-797-1726",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "WY",
            "license": "LCSW 800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Casper, WY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2012; 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.