Organization
COMPLETE CARE COUNSELING, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CODIE LYNN WALLACE LCSW (OWNER)
(307) 797-1726
Entity
Organization
Contact information
Practice address
2510 E 15TH ST, SUITE 11, CASPER, WY 82609-4111
(307) 234-9979
(307) 234-9989
Mailing address
2510 E 15TH ST, SUITE 11, CASPER, WY 82609-4111
(307) 234-9979
(307) 234-9989
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW 800
WY
Other
Enumeration date
10/02/2012
Last updated
10/02/2012
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