Provider Demographics
NPI:1639593080
Name:CAPITOL COUNSELING, LLC
Entity Type:Organization
Organization Name:CAPITOL COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:L
Authorized Official - Last Name:WRIEDT-BYRNE
Authorized Official - Suffix:
Authorized Official - Credentials:MS,LPC, NCC
Authorized Official - Phone:307-631-5574
Mailing Address - Street 1:1918 THOMES AVE
Mailing Address - Street 2:
Mailing Address - City:CHEYENNE
Mailing Address - State:WY
Mailing Address - Zip Code:82001-3527
Mailing Address - Country:US
Mailing Address - Phone:307-631-5574
Mailing Address - Fax:307-514-5751
Practice Address - Street 1:1918 THOMES AVE
Practice Address - Street 2:
Practice Address - City:CHEYENNE
Practice Address - State:WY
Practice Address - Zip Code:82001-3527
Practice Address - Country:US
Practice Address - Phone:307-631-5574
Practice Address - Fax:307-514-5751
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-05
Last Update Date:2015-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WYLPC-824101YP2500X
WYLPC-483101YP2500X
WYLPC-1425101YP2500X
WYLCSW-5751041C0700X
WY2084P0800X
WYLPC-1122101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WY1972604874Medicaid
WY1700841681Medicaid
WY1578735940Medicaid
WY1912347469Medicaid
WY1508016023Medicaid