Provider Demographics
NPI:1205685179
Name:HUMMINGBIRD COUNSELING & PLAY THERAPY LLC
Entity type:Organization
Organization Name:HUMMINGBIRD COUNSELING & PLAY THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MENTAL HEALTH COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:DEANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:LEDERER
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:307-429-2044
Mailing Address - Street 1:2161 COFFEEN AVE STE 402
Mailing Address - Street 2:
Mailing Address - City:SHERIDAN
Mailing Address - State:WY
Mailing Address - Zip Code:82801-5771
Mailing Address - Country:US
Mailing Address - Phone:307-675-1187
Mailing Address - Fax:
Practice Address - Street 1:2161 COFFEEN AVE STE 402
Practice Address - Street 2:
Practice Address - City:SHERIDAN
Practice Address - State:WY
Practice Address - Zip Code:82801-5771
Practice Address - Country:US
Practice Address - Phone:307-429-2044
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-14
Last Update Date:2024-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty