Provider Demographics
NPI:1467519272
Name:SOUTHWEST COUNSELING
Entity Type:Organization
Organization Name:SOUTHWEST COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER CHILD-ADOLESCENT SERVICES
Authorized Official - Prefix:MS
Authorized Official - First Name:MICHAL
Authorized Official - Middle Name:ZANNETTI
Authorized Official - Last Name:LOVE
Authorized Official - Suffix:
Authorized Official - Credentials:LPSW
Authorized Official - Phone:307-352-6680
Mailing Address - Street 1:2312 BITTER CREEK TRL
Mailing Address - Street 2:
Mailing Address - City:ROCK SPRINGS
Mailing Address - State:WY
Mailing Address - Zip Code:82901-6583
Mailing Address - Country:US
Mailing Address - Phone:307-389-1963
Mailing Address - Fax:
Practice Address - Street 1:1124 COLLEGE DR
Practice Address - Street 2:
Practice Address - City:ROCK SPRINGS
Practice Address - State:WY
Practice Address - Zip Code:82901-5863
Practice Address - Country:US
Practice Address - Phone:307-352-6680
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-02
Last Update Date:2008-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WYPCSW-200251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare