| Eagle Rock Counseling Services | |
|
235 E Main St Lovell WY 82431-2101 | |
| (307) 272-8798 | |
| Not Available |
| Full Name | Eagle Rock Counseling Services |
|---|---|
| Speciality | Counselor |
| Location | 235 E Main St, Lovell, Wyoming |
| Authorized Official Name and Position | Charles Cordova (OWNER) |
| Authorized Official Contact | 3072728798 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Eagle Rock Counseling Services 730 Montana Ave Lovell WY 82431-1810 Ph: (307) 272-8798 | Eagle Rock Counseling Services 235 E Main St Lovell WY 82431-2101 Ph: (307) 272-8798 |
| NPI Number | 1699537894 |
|---|---|
| Provider Enumeration Date | 01/24/2024 |
| Last Update Date | 02/29/2024 |
| Certification Date | 02/29/2024 |
| Medicare PECOS PAC ID | 9234574245 |
|---|---|
| Medicare Enrollment ID | O20240229002576 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699537894 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
| Provider Name | Charles Joseph Cordova |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1073978920 PECOS PAC ID: 0143665158 Enrollment ID: I20240229002661 |
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