Organization
BRAIN INJURY ASSOCIATION OF WYOMING
Active
Other names
Brain Injury Advocates of Wyoming, Brain Injury Alliance of Wyoming
Organization subpart
No
Provider details
NPI number
Authorized official
DANIEL CUBBEDGE (EXECUTIVE DIRECTOR)
(307) 473-1767
Entity
Organization
Contact information
Practice address
350 BIG HORN RD STE 101, CASPER, WY 82601-1782
(307) 473-1767
Mailing address
PO BOX 2984, CASPER, WY 82602-2984
(307) 473-1767
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
—
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
—
—
1041S0200X
School Social Worker
—
—
106E00000X
Assistant Behavior Analyst
—
—
106S00000X
Behavior Technician
—
—
171M00000X
Case Manager/Care Coordinator
—
—
251B00000X
Case Management Agency
—
—
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
139437100
—
WY
05
—
139437101
—
WY
05
—
214737800
—
WY
05
—
221397400
—
WY
Enumeration date
06/17/2014
Last updated
05/13/2025
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