Provider Demographics
NPI:1396162046
Name:TAKE TIME COUNSELING
Entity type:Organization
Organization Name:TAKE TIME COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CLINICAL THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:FAILES
Authorized Official - Suffix:
Authorized Official - Credentials:MS LPC LAT
Authorized Official - Phone:307-262-2787
Mailing Address - Street 1:PO BOX 1375
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:WY
Mailing Address - Zip Code:82636-1375
Mailing Address - Country:US
Mailing Address - Phone:307-262-2787
Mailing Address - Fax:307-234-9989
Practice Address - Street 1:2510 E 15TH ST
Practice Address - Street 2:SUITE11
Practice Address - City:CASPER
Practice Address - State:WY
Practice Address - Zip Code:82609-4111
Practice Address - Country:US
Practice Address - Phone:307-262-2787
Practice Address - Fax:307-234-9989
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-19
Last Update Date:2014-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WYLAT 269101YA0400X, 251S00000X
WYLPC 732101YM0800X, 251S00000X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Single Specialty