Dionis Risto, | |
640 E Broadway Ave, Jackson, WY 83001-8642 | |
(307) 733-2046 | |
(307) 733-6289 |
Full Name | Dionis Risto |
---|---|
Gender | Male |
Speciality | Social Worker - Clinical |
Location | 640 E Broadway Ave, Jackson, Wyoming |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1285140293 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1041C0700X | Social Worker - Clinical | LCSW-1635 (Wyoming) | Primary |
Entity Name | Mental Health & Recovery Services Of Jackson Hole |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1578635462 PECOS PAC ID: 0840272472 Enrollment ID: O20040607000292 |
Mailing Address | Practice Location Address |
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Dionis Risto, Po Box 11390, Jackson, WY 83002-1390 Ph: () - | Dionis Risto, 640 E Broadway Ave, Jackson, WY 83001-8642 Ph: (307) 733-2046 |
Leah Black, LCSW Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 310 E Broadway Ave, Jackson, WY 83001 Phone: 307-654-7003 Fax: 307-224-4973 | |
Jean Abrams, LCSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 4180 Gregory Lane, Jackson, WY 83001 Phone: 307-734-6040 | |
Mrs. Stephanie Capps, MSW, PCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 640 E Broadway Ave, Jackson, WY 83001 Phone: 307-733-2046 | |
Jamie R Lasden, Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 690 S Ushwy 89, Suite 201, Jackson, WY 83001 Phone: 781-254-0304 | |
Lauren E Furtney, LCSW Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 1415 S Hwy 89, Jackson, WY 83001 Phone: 307-739-8999 Fax: 307-739-4811 | |
Tara Singh, LCSW Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 640 E Broadway Ave, Jackson, WY 83001 Phone: 307-733-2046 Fax: 307-733-6289 | |
Cheyenne Lyn Syvertson-hagestuen, MSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 501 S Cache Street, Jackson, WY 83001 Phone: 307-733-7946 |