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Organization
HIGH COUNTRY BEHAVIORAL HEALTH
Active
Organization
HIGH COUNTRY BEHAVIORAL HEALTH
Active
Other names
Wellspring Counseling
Organization subpart
No
Provider details
NPI number
Authorized official
KIPP DANA LPC, LAT (CEO)
(307) 885-9883
Entity
Organization
Contact information
Practice address
121 S 4TH ST, THERMOPOLIS, WY 82443-2634
(307) 864-3138
(307) 864-3139
Mailing address
121 S 4TH ST, THERMOPOLIS, WY 82443-2634
(307) 864-3138
(307) 864-3139
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207QA0401X
Addiction Medicine (Family Medicine) Physician
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
291U00000X
Clinical Medical Laboratory
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
108969204
—
WY
Enumeration date
05/01/2007
Last updated
06/08/2022
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