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Organization

SPECIALTY COUNSELING & CONSULTING

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. ROBERT LOGAN LPC (OWNER/OPERATOR)
(307) 426-4798
Entity
Organization

Contact information

Practice address
4025 RAWLINS ST, CHEYENNE, WY 82001-1900
(307) 426-4798
(307) 426-4799
Mailing address
4025 RAWLINS ST, CHEYENNE, WY 82001-1900
(307) 426-4798
(307) 426-4798

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
PHD-419
WY
2084P0800X
Psychiatry Physician
15431
CO
251S00000X
Community/Behavioral Health Agency
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
130259100
WY
05
9000142271
CO
Enumeration date
12/09/2010
Last updated
01/03/2025
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