Individual
MISS CHINNA L. MACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, LCSW
Contact information
Practice address
300 EAST 17TH ST, CHEYENNE, WY 82001-4608
(307) 631-9931
(307) 635-7706
Mailing address
300 EAST 17TH ST, CHEYENNE, WY 82001-4608
(307) 631-9931
(307) 635-7706
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
CSW-238
WY
104100000X
Social Worker
LCSW-1777
WY
1041C0700X
Clinical Social Worker
Primary
LCSW-1777
WY
1041C0700X
Clinical Social Worker
PCSW-1036
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
138289600
—
WY
Enumeration date
12/15/2014
Last updated
03/03/2026
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