Individual
JOHN CUSULOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.A., LP.C., LAT
Contact information
Practice address
1430 WILKINS CIRCLE, CASPER, WY 82601
(307) 237-9583
(307) 265-7277
Mailing address
1430 WILKINS CIRCLE, CASPER, WY 82601
(307) 237-9583
(307) 265-7277
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LAT-154
WY
101YP2500X
Professional Counselor
Primary
LPC-452
WY
Other
Enumeration date
01/07/2009
Last updated
01/07/2009
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