Provider Demographics
NPI:1477850428
Name:OSTRANDER, CHARLES WESLEY (LPC)
Entity Type:Individual
Prefix:MR
First Name:CHARLES
Middle Name:WESLEY
Last Name:OSTRANDER
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1604
Mailing Address - Street 2:
Mailing Address - City:CHEYENNE
Mailing Address - State:WY
Mailing Address - Zip Code:82003-1604
Mailing Address - Country:US
Mailing Address - Phone:307-635-0256
Mailing Address - Fax:307-635-0967
Practice Address - Street 1:1920 THOMES AVE
Practice Address - Street 2:SUITE 320
Practice Address - City:CHEYENNE
Practice Address - State:WY
Practice Address - Zip Code:82001-3542
Practice Address - Country:US
Practice Address - Phone:307-635-0256
Practice Address - Fax:307-635-0967
Is Sole Proprietor?:No
Enumeration Date:2011-02-25
Last Update Date:2011-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WYLPC-797101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)