Provider Demographics
NPI:1982449310
Name:PIONEER COUNSELING SERVICES
Entity type:Organization
Organization Name:PIONEER COUNSELING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DOROTHY
Authorized Official - Middle Name:
Authorized Official - Last Name:CONGER
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:307-789-7915
Mailing Address - Street 1:350 CITY VIEW DR STE 206
Mailing Address - Street 2:
Mailing Address - City:EVANSTON
Mailing Address - State:WY
Mailing Address - Zip Code:82930-5326
Mailing Address - Country:US
Mailing Address - Phone:307-789-7915
Mailing Address - Fax:307-789-6009
Practice Address - Street 1:85 PARK RD
Practice Address - Street 2:#1
Practice Address - City:EVANSTON
Practice Address - State:WY
Practice Address - Zip Code:82930
Practice Address - Country:US
Practice Address - Phone:307-789-7915
Practice Address - Fax:307-789-6009
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PIONEER COUNSELING SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-06-27
Last Update Date:2024-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness