| Livingwater Counseling | |
|
411 S Walsh Dr Casper WY 82609-2306 | |
| (307) 336-3770 | |
| Not Available |
| Full Name | Livingwater Counseling |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 411 S Walsh Dr, Casper, Wyoming |
| Authorized Official Name and Position | Elizabeth Joan Kornkven (PRESIDENT) |
| Authorized Official Contact | 3073333060 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Livingwater Counseling 5311 S David St Casper WY 82601-6339 Ph: (307) 333-3060 | Livingwater Counseling 411 S Walsh Dr Casper WY 82609-2306 Ph: (307) 336-3770 |
| NPI Number | 1093581894 |
|---|---|
| Provider Enumeration Date | 12/01/2023 |
| Last Update Date | 12/01/2023 |
| Certification Date | 11/30/2023 |
| Medicare PECOS PAC ID | 3779920269 |
|---|---|
| Medicare Enrollment ID | O20240320000059 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093581894 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Elizabeth Joan Kornkven |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1730460932 PECOS PAC ID: 4688011174 Enrollment ID: I20240320000086 |
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