Outside Therapy Llc | |
1918 Thomes Ave Cheyenne WY 82001-3527 | |
(307) 313-2777 | |
Not Available |
Full Name | Outside Therapy Llc |
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Speciality | Counselor |
Location | 1918 Thomes Ave, Cheyenne, Wyoming |
Authorized Official Name and Position | Alyse Pfankuch (THERAPIST) |
Authorized Official Contact | 3072210317 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Outside Therapy Llc 4726 Mountain Rd Apt 520 Cheyenne WY 82009-5157 Ph: (307) 221-0317 | Outside Therapy Llc 1918 Thomes Ave Cheyenne WY 82001-3527 Ph: (307) 313-2777 |
NPI Number | 1902652274 |
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Provider Enumeration Date | 04/27/2024 |
Last Update Date | 01/23/2025 |
Certification Date | 01/23/2025 |
Medicare PECOS PAC ID | 8628519899 |
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Medicare Enrollment ID | O20240916003242 |
Identifier | Type | State | Issuer |
---|---|---|---|
1902652274 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
Provider Name | Whitney Mcshane |
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Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1962167098 PECOS PAC ID: 8325581366 Enrollment ID: I20240619001068 |
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