| La Familia Counseling Services | |
|
140 E Broadway Ave Ste B-13 Jackson WY 83001-8632 | |
| (307) 413-6528 | |
| Not Available |
| Full Name | La Familia Counseling Services |
|---|---|
| Speciality | Counselor |
| Location | 140 E Broadway Ave Ste B-13, Jackson, Wyoming |
| Authorized Official Name and Position | Daniela Francisca Peterson (OWNER) |
| Authorized Official Contact | 3074136528 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| La Familia Counseling Services 825 Hi Country Dr Jackson WY 83001-9442 Ph: (307) 413-6528 | La Familia Counseling Services 140 E Broadway Ave Ste B-13 Jackson WY 83001-8632 Ph: (307) 413-6528 |
| NPI Number | 1053771287 |
|---|---|
| Provider Enumeration Date | 03/01/2016 |
| Last Update Date | 03/01/2016 |
| Medicare PECOS PAC ID | 3375967987 |
|---|---|
| Medicare Enrollment ID | O20200715002492 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053771287 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 1071 (Wyoming) | Primary |
| 103T00000X | Psychologist | 136 (Wyoming) | Secondary |
| Provider Name | Joyce C Surdam |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1336478643 PECOS PAC ID: 3678697620 Enrollment ID: I20100827000976 |
Jackson Hole Mental Health Llc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 310 E Broadway Ave, Jackson, WY 83001 Phone: 307-654-7003 | |
Root To Rise Counseling And Consulting Pllc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 970 West Broadway Avenue, Suite 212b3, Jackson, WY 83001 Phone: 208-243-8507 Fax: 307-460-7416 | |
Snake River Consulting Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 430 Pine Dr, Jackson, WY 83001 Phone: 307-699-3996 | |
Steven Nelson, Phd, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 140 E. Broadway Ave., Suite 25, Jackson, WY 83001 Phone: 307-739-9500 Fax: 307-733-2837 | |
East Jackson Mental Health Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 580 E Broadway Ave, Jackson, WY 83001 Phone: 307-201-1385 | |
Nicole Rue, Psy.d., Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1115 Maple Way Ste D, Jackson, WY 83001 Phone: 307-690-2763 |