| Kimberly Maffei Lcsw, Llc | |
|
2020 E Grand Ave Ste 409 Laramie WY 82070-4383 | |
| (307) 399-0435 | |
| Not Available |
| Full Name | Kimberly Maffei Lcsw, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 2020 E Grand Ave Ste 409, Laramie, Wyoming |
| Authorized Official Name and Position | Kimberly Maffei (MENTAL HEALTH THERAPIST) |
| Authorized Official Contact | 3073990435 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kimberly Maffei Lcsw, Llc 911 Sanders Dr Laramie WY 82070-4650 Ph: (307) 399-0435 | Kimberly Maffei Lcsw, Llc 2020 E Grand Ave Ste 409 Laramie WY 82070-4383 Ph: (307) 399-0435 |
| NPI Number | 1124771910 |
|---|---|
| Provider Enumeration Date | 02/01/2022 |
| Last Update Date | 02/01/2022 |
| Certification Date | 02/01/2022 |
| Medicare PECOS PAC ID | 8123413911 |
|---|---|
| Medicare Enrollment ID | O20220324002771 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124771910 | NPI | - | NPPES |
| 139989600 | Medicaid | WY | |
| 212102600 | Medicaid | WY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Kimberly Sue Maffei |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1841687233 PECOS PAC ID: 6406241298 Enrollment ID: I20220314001230 |
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