Provider Demographics
NPI:1164660338
Name:ORPET-BLACKETT, TARYN LYNN
Entity type:Individual
Prefix:MRS
First Name:TARYN
Middle Name:LYNN
Last Name:ORPET-BLACKETT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:TARYN
Other - Middle Name:LYNN
Other - Last Name:ORPET
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3900 TEN MILE RD
Mailing Address - Street 2:
Mailing Address - City:CASPER
Mailing Address - State:WY
Mailing Address - Zip Code:82604-2894
Mailing Address - Country:US
Mailing Address - Phone:307-277-2955
Mailing Address - Fax:307-235-4619
Practice Address - Street 1:970 N GLENN RD
Practice Address - Street 2:
Practice Address - City:CASPER
Practice Address - State:WY
Practice Address - Zip Code:82601-1635
Practice Address - Country:US
Practice Address - Phone:307-253-5200
Practice Address - Fax:307-235-4619
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-27
Last Update Date:2023-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WYLPC-1422101Y00000X, 101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health