Individual
TESSA MATZEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PCSW
Contact information
Practice address
1607 CAPITOL AVE FL THE2, CHEYENNE, WY 82001-4525
(307) 630-4729
(307) 632-3298
Mailing address
4989 N 3RD ST, LARAMIE, WY 82072-9548
(307) 745-8997
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
PCSW-685
WY
104100000X
Social Worker
PCSW-685
WY
1041C0700X
Clinical Social Worker
Primary
LCSW-1130
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LCSW-1130
LICENSED CLINICAL SOCIAL WORKER
WY
01
—
PCSW-685
STATE LICENSE
WY
Enumeration date
11/07/2016
Last updated
07/23/2018
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