Provider Demographics
NPI:1962010025
Name:CARRICK, AUBRIANNA S (CSW)
Entity Type:Individual
Prefix:
First Name:AUBRIANNA
Middle Name:S
Last Name:CARRICK
Suffix:
Gender:F
Credentials:CSW
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 50304
Mailing Address - Street 2:
Mailing Address - City:CASPER
Mailing Address - State:WY
Mailing Address - Zip Code:82605-0304
Mailing Address - Country:US
Mailing Address - Phone:307-921-9993
Mailing Address - Fax:
Practice Address - Street 1:933 W 14TH ST
Practice Address - Street 2:
Practice Address - City:CASPER
Practice Address - State:WY
Practice Address - Zip Code:82601-3561
Practice Address - Country:US
Practice Address - Phone:307-321-9993
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-15
Last Update Date:2020-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WYCSW-325101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor