# MOURNING GLORY COUNSELING LLC

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

## Provider details

- **NPI number:** 1902340326
- **Authorized official:** MRS. TISA M SUCHER LCSW (LICENSED CLINICAL SOCIAL WORKER)
- **Authorized official phone:** (307) 235-3333

## Contact information

- **Practice address:** 1300 E A ST STE 201, CASPER, WY 82601-2252
- **Practice address phone:** (307) 235-3333
- **Practice address fax:** (307) 266-5155
- **Mailing address:** 1300 E A ST STE 201, CASPER, WY 82601-2252
- **Mailing address phone:** (307) 235-3333
- **Mailing address fax:** (307) 266-5155

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1041C0700X | Clinical Social Worker | 456 | WY | Yes |

## Other

- **Enumeration date:** 12/05/2016
- **Last updated:** 12/05/2016