| Clear Creek Counseling Llc | |
|
801 E. 4th St. Suite 24 Gillette WY 82716 | |
| (307) 686-9422 | |
| (307) 686-3833 |
| Full Name | Clear Creek Counseling Llc |
|---|---|
| Speciality | Counselor |
| Location | 801 E. 4th St., Gillette, Wyoming |
| Authorized Official Name and Position | Dale F. Oedekoven (CO-OWNER) |
| Authorized Official Contact | 3076869422 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Clear Creek Counseling Llc 801 E. 4th St. Suite 24 Gillette WY 82716 Ph: (307) 686-9422 | Clear Creek Counseling Llc 801 E. 4th St. Suite 24 Gillette WY 82716 Ph: (307) 686-9422 |
| NPI Number | 1083937486 |
|---|---|
| Provider Enumeration Date | 03/12/2010 |
| Last Update Date | 04/21/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083937486 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | LPC540 (Wyoming) | Secondary |
| 101Y00000X | Counselor | LPC-372 (Wyoming) | Primary |
| 251S00000X | Community/behavioral Health | 540 (Wyoming) | Secondary |
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