Provider Demographics
NPI:1821664103
Name:HUNTER, CARLY JO (MS, LPC, NCC)
Entity Type:Individual
Prefix:MRS
First Name:CARLY
Middle Name:JO
Last Name:HUNTER
Suffix:
Gender:F
Credentials:MS, LPC, NCC
Other - Prefix:MS
Other - First Name:CARLY
Other - Middle Name:JO
Other - Last Name:JENSEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1401 W 2ND ST UNIT 1
Mailing Address - Street 2:
Mailing Address - City:GILLETTE
Mailing Address - State:WY
Mailing Address - Zip Code:82716-3334
Mailing Address - Country:US
Mailing Address - Phone:307-682-6699
Mailing Address - Fax:307-582-6698
Practice Address - Street 1:1401 W 2ND ST UNIT 1
Practice Address - Street 2:
Practice Address - City:GILLETTE
Practice Address - State:WY
Practice Address - Zip Code:82716-3334
Practice Address - Country:US
Practice Address - Phone:307-682-6699
Practice Address - Fax:307-582-6698
Is Sole Proprietor?:No
Enumeration Date:2021-05-27
Last Update Date:2024-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WYLPC-2237101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional