Trauma And Supportive Counseling Tasc | |
1705 Albany Ave Ste 800 Cheyenne WY 82001-5027 | |
(307) 757-6014 | |
Not Available |
Full Name | Trauma And Supportive Counseling Tasc |
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Speciality | Social Worker |
Location | 1705 Albany Ave Ste 800, Cheyenne, Wyoming |
Authorized Official Name and Position | Sandra Brausch (OWNER/AUTHORIZED OFFICIAL) |
Authorized Official Contact | 3037576014 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Trauma And Supportive Counseling Tasc 1705 Albany Ave Ste 800 Cheyenne WY 82001-5027 Ph: (303) 757-6014 | Trauma And Supportive Counseling Tasc 1705 Albany Ave Ste 800 Cheyenne WY 82001-5027 Ph: (307) 757-6014 |
NPI Number | 1770200602 |
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Provider Enumeration Date | 10/21/2022 |
Last Update Date | 08/25/2023 |
Certification Date | 08/25/2023 |
Medicare PECOS PAC ID | 4688043052 |
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Medicare Enrollment ID | O20221206002561 |
Identifier | Type | State | Issuer |
---|---|---|---|
1770200602 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
Provider Name | Sandra J Brausch |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1932282837 PECOS PAC ID: 4385056399 Enrollment ID: I20201216001761 |
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