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Douglas Blocksma, MA
Professional Counselor in Cheyenne, Wyoming
NPI 1154687465

Douglas Blocksma is a Professional Counselor based in Cheyenne, WY and is specialized in Professional. Douglas Blocksma practices in Cheyenne, WY and has the professional credentials of MA. The NPI Number for Douglas Blocksma is 1154687465 and holds a License No. NLC-13914 (Wyoming).

The current practice location address for Douglas Blocksma is 719 E 17Th St, Cheyenne, WY and can be reached out via phone at 307-509-0772 and via fax at 307-426-4133.

Location: 719 E 17Th St, Cheyenne, WY, 82001-4711
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Provider Profile Details
NPI Number
1154687465
Provider Name
Douglas Blocksma
Credential
MA
Provider Entity Type
Individual
Gender
Male
Address
719 E 17Th St, Cheyenne, WY, 82001-4711
Phone Number
307-509-0772
Fax Number
307-426-4133
Provider Enumeration Date
04/11/2012
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
27-2932236 01 WY EMPLOYEE IDENTIFICATION NUMBER
institution
Provider Business Practice Location Address Details
Address
719 E 17Th St
City
State
Zip
82001-4711
Phone Number
307-509-0772
Fax Number
307-426-4133
person
Provider Business Mailing Address Details
Address
719 E 17Th St
City
State
Zip
82001-4711
Phone Number
307-509-0772
Fax Number
307-426-4133
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
License No.
LPC-1410 (Wyoming)
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Professional
Taxonomy
License No.
NLC-13914 (Colorado)
Definition
Definition to come...
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