Provider Demographics
NPI:1992958664
Name:KIRCHHOFF, MAUREEN GAIL (LCSW)
Entity type:Individual
Prefix:MS
First Name:MAUREEN
Middle Name:GAIL
Last Name:KIRCHHOFF
Suffix:
Gender:F
Credentials:LCSW
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 134
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:WY
Mailing Address - Zip Code:82836
Mailing Address - Country:US
Mailing Address - Phone:307-763-6807
Mailing Address - Fax:
Practice Address - Street 1:VOA OUTPATIENT CLINIC, 1221 W. FIFTH ST.
Practice Address - Street 2:
Practice Address - City:SHERIDAN
Practice Address - State:WY
Practice Address - Zip Code:82801
Practice Address - Country:US
Practice Address - Phone:307-674-4405
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-28
Last Update Date:2023-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WYLCSW3181041C0700X
WYLCSW10271041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical