Provider Demographics
NPI:1477051860
Name:GIVENS, MISSYBETH E (MS, LPC)
Entity Type:Individual
Prefix:
First Name:MISSYBETH
Middle Name:E
Last Name:GIVENS
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11137 STATE HIGHWAY 789
Mailing Address - Street 2:
Mailing Address - City:RIVERTON
Mailing Address - State:WY
Mailing Address - Zip Code:82501-8810
Mailing Address - Country:US
Mailing Address - Phone:307-851-4042
Mailing Address - Fax:
Practice Address - Street 1:11137 STATE HIGHWAY 789
Practice Address - Street 2:
Practice Address - City:RIVERTON
Practice Address - State:WY
Practice Address - Zip Code:82501-8810
Practice Address - Country:US
Practice Address - Phone:307-851-4042
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-31
Last Update Date:2024-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WYLPC-1524101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional