Organization
HIGH COUNTRY BEHAVIORAL HEALTH
Active
Other names
High Country Counseling and Resource Centers
Organization subpart
No
Provider details
NPI number
Authorized official
KIPP L DANA LPC-LAT (EXECUTIVE DIRECTOR)
(307) 885-9883
Entity
Organization
Contact information
Practice address
389 ADAMS ST., AFTON, WY 83110-0376
(307) 885-9883
(307) 885-5206
Mailing address
PO BOX 376, AFTON, WY 83110-0376
(307) 885-9883
(307) 885-5206
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207QA0401X
Addiction Medicine (Family Medicine) Physician
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
405
WY
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
LPC-550
WY
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
LAT-220
WY
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
291U00000X
Clinical Medical Laboratory
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
117699401
—
WY
05
—
117847400
—
WY
Enumeration date
04/03/2007
Last updated
06/08/2022
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