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Kintsugi Psychiatry, Llc
Psychiatric/Mental Health Nurse Practitioner in Casper, Wyoming
NPI 1306406509

Kintsugi Psychiatry, Llc is a Psychiatric/Mental Health Nurse Practitioner based in Casper, WY and is specialized in Psychiatric/Mental Health. Kintsugi Psychiatry, Llc practices in Casper, WY. The NPI Number for Kintsugi Psychiatry, Llc is 1306406509 and holds a License No. (Wyoming).

The current practice location address for Kintsugi Psychiatry, Llc is 145 S Durbin St Ste 108, Casper, WY and can be reached out via phone at 307-333-5757 and via fax at 307-439-2141.

Location: 145 S Durbin St Ste 108, Casper, WY, 82602-1117
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1306406509
Provider Name
Kintsugi Psychiatry, Llc
Credential
Provider Entity Type
Organization
Address
145 S Durbin St Ste 108, Casper, WY, 82602-1117
Phone Number
307-333-5757
Fax Number
307-439-2141
Provider Enumeration Date
06/19/2019
Last Update Date
03/10/2024
tick
Provider's Legacy Identifiers
Identifier Type State Issuer
1306406509 05 WY
1093117210 05 WY
institution
Provider Business Practice Location Address Details
Address
145 S Durbin St Ste 108
City
Casper
State
Wyoming
Zip
82601-2566
Phone Number
307-333-5757
Fax Number
307-439-2141
person
Provider Business Mailing Address Details
Address
145 S Durbin St Ste 108
City
Casper
State
Wyoming
Zip
82601-2566
Phone Number
307-333-5757
Fax Number
307-439-2141
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Adult Mental Health
Taxonomy
261QM0850X
License No.
()
Definition
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults.
person
Provider's Taxonomy Details 2
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Adolescent and Children Mental Health
Taxonomy
261QM0855X
License No.
()
Definition
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in children and adolescents. Services may be provided to parents and family members of the patient in the form of conjoint, group, or individual therapy, and education and/or training.
person
Provider's Taxonomy Details 3
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Psychiatric/Mental Health
Taxonomy
363LP0808X
License No.
()
Definition
Definition to come...
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