Organization
THE CLINIC FOR MENTAL HEALTH & WELLNESS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARTHA NESSLNGER MA, LPC (LICENSED PROFESSIONAL COUNSELOR)
(307) 755-1000
Entity
Organization
Contact information
Practice address
504 S 4TH ST, LARAMIE, WY 82070-3704
(307) 755-1000
(307) 742-9717
Mailing address
504 S 4TH ST, LARAMIE, WY 82070-3704
(307) 755-1000
(307) 742-9717
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
LPC#1027
WY
101Y00000X
Counselor
LPC#290
WY
101YA0400X
Addiction (Substance Use Disorder) Counselor
LAT#265
WY
1041C0700X
Clinical Social Worker
LCSW#176
WY
Other
Enumeration date
04/13/2011
Last updated
04/13/2011
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