# LIVING WELL PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1326342023
- **Authorized official:** TRICIA R MILLER MSW (PRESIDENT)
- **Authorized official phone:** (307) 234-9979

## Contact information

- **Practice address:** 2510 E 15TH ST, SUITE 11, CASPER, WY 82609-4111
- **Practice address phone:** (307) 234-9979
- **Practice address fax:** (307) 234-9989
- **Mailing address:** 2510 E 15TH ST, SUITE 11, CASPER, WY 82609-4111
- **Mailing address phone:** (307) 234-9979
- **Mailing address fax:** (307) 234-9989

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 103TC0700X | Clinical Psychologist | 465 | WY | — |
| 1041C0700X | Clinical Social Worker | 603 | WY | Yes |
| 251S00000X | Community/Behavioral Health Agency | — | NULL | — |

## Other

- **Enumeration date:** 01/10/2011
- **Last updated:** 05/01/2015