Organization
PARK RIDGE BEHAVIORAL HEALTHCARE, LLC
Active
Other names
Park Ridge Psychological Services
Organization subpart
No
Provider details
NPI number
Authorized official
BRANDON WARDELL DBH, MAMFT, NCC, LPC (PRESIDENT)
(405) 412-5468
Entity
Organization
Contact information
Practice address
940 E 3RD ST STE 104, CASPER, WY 82601-3200
(307) 462-4876
Mailing address
301 THELMA DR STE 226, CASPER, WY 82609
(405) 412-5468
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
211930700
—
WY
Enumeration date
09/10/2009
Last updated
11/13/2024
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