Provider Demographics
NPI:1235561507
Name:BEDIENT, JAMES ROBERT ALLEN BEDIENT (MA)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:ROBERT ALLEN BEDIENT
Last Name:BEDIENT
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:802 E 18TH AVE
Mailing Address - Street 2:
Mailing Address - City:TORRINGTON
Mailing Address - State:WY
Mailing Address - Zip Code:82240-3029
Mailing Address - Country:US
Mailing Address - Phone:307-401-0598
Mailing Address - Fax:
Practice Address - Street 1:2802 W C ST
Practice Address - Street 2:
Practice Address - City:TORRINGTON
Practice Address - State:WY
Practice Address - Zip Code:82240-1834
Practice Address - Country:US
Practice Address - Phone:307-532-0134
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-08
Last Update Date:2023-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WYPPC-1303101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor