SOMATIC REVELATIONS LLC NPI 1285251967

NPI Information

NPI: 1285251967
Provider Name: SOMATIC REVELATIONS, LLC
Classification: Counselor - 101YM0800X
Entity Type: Organization

Specialization: Mental Health

Address:
2020 E GRAND AVE STE 506
LARAMIE, WY
ZIP 82070
Phone: (307) 200-9228
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SOMATIC REVELATIONS, LLC is a mental health counselor in Laramie, WY. SOMATIC REVELATIONS, LLC NPI is 1285251967. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

2020 E GRAND AVE STE 506
LARAMIE, WY
ZIP 82070-370
Phone: (307) 200-9228
Fax: (307) 460-9084

The provider's authorized official is Tyler S. Tedmon-jones .
The authorized official title is Owner/operator and has the following contact phone number (412) 760-2447.

The enumeration date for this NPI number is 6/29/2020 and was last updated on 6/29/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	225600000X	Dance Therapist				No
2	101YM0800X	Counselor	Mental Health			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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