Organization
CLEAR CREEK COUNSELING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DALE F. OEDEKOVEN MA, LPC, LAT, NCC (CO-OWNER)
(307) 686-9422
Entity
Organization
Contact information
Practice address
801 E. 4TH ST., SUITE 24, GILLETTE, WY 82716
(307) 686-9422
(307) 686-3833
Mailing address
801 E. 4TH ST., SUITE 24, GILLETTE, WY 82716
(307) 686-9422
(307) 686-3833
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
LPC-372
WY
101Y00000X
Counselor
LPC540
WY
251S00000X
Community/Behavioral Health Agency
540
WY
Other
Enumeration date
03/12/2010
Last updated
04/21/2010
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