Provider Demographics
NPI:1932458734
Name:A POSITIVE SOLUTION COUNSELING CENTER, LLC
Entity Type:Organization
Organization Name:A POSITIVE SOLUTION COUNSELING CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:BONITA
Authorized Official - Middle Name:SUE
Authorized Official - Last Name:MORISETTE
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, LCSW-462
Authorized Official - Phone:307-682-3747
Mailing Address - Street 1:201 W LAKEWAY RD
Mailing Address - Street 2:SUITE 1004
Mailing Address - City:GILLETTE
Mailing Address - State:WY
Mailing Address - Zip Code:82718-6361
Mailing Address - Country:US
Mailing Address - Phone:307-682-3747
Mailing Address - Fax:307-682-3748
Practice Address - Street 1:201 W LAKEWAY RD
Practice Address - Street 2:SUITE 1004
Practice Address - City:GILLETTE
Practice Address - State:WY
Practice Address - Zip Code:82718-6361
Practice Address - Country:US
Practice Address - Phone:307-682-3747
Practice Address - Fax:307-682-3748
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-07
Last Update Date:2012-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY516101YP2500X
WY386103T00000X
WY4621041C0700X
WY170106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty