Organization
FAMILY DYNAMICS COUNSELING, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JILL A JOHNSON MS LMFT (PRESIDENT)
(307) 382-3010
Entity
Organization
Contact information
Practice address
4000 DEWAR DR, ROCK SPRINGS, WY 82901-6218
(307) 382-3010
(307) 382-6881
Mailing address
4000 DEWAR DR, ROCK SPRINGS, WY 82901-6218
(307) 382-3010
(307) 382-6881
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YP2500X
Professional Counselor
Primary
—
—
1041C0700X
Clinical Social Worker
—
—
106H00000X
Marriage & Family Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3200001
BCBS OF WYOMING
WY
Enumeration date
04/01/2008
Last updated
04/14/2015
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