Provider Demographics
NPI:1023263159
Name:ASPEN CREEK COUNSELING ASSOCIATES, LLC
Entity type:Organization
Organization Name:ASPEN CREEK COUNSELING ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MENTAL HEALTH THERAPIST/CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOELLEN
Authorized Official - Middle Name:
Authorized Official - Last Name:JORGENSEN
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:307-233-4210
Mailing Address - Street 1:800 WERNER CT
Mailing Address - Street 2:SUITE 235
Mailing Address - City:CASPER
Mailing Address - State:WY
Mailing Address - Zip Code:82601-1326
Mailing Address - Country:US
Mailing Address - Phone:307-233-4210
Mailing Address - Fax:307-233-4213
Practice Address - Street 1:800 WERNER CT
Practice Address - Street 2:SUITE 235
Practice Address - City:CASPER
Practice Address - State:WY
Practice Address - Zip Code:82601-1326
Practice Address - Country:US
Practice Address - Phone:307-233-4210
Practice Address - Fax:307-233-4213
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-17
Last Update Date:2008-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WYLPC726251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health