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Contact Information

SUPPORTIVE CARE OF WYOMING LLC
2700 E 12TH ST
CHEYENNE, WY82001-5604
 Phone: 718-506-1115
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Clinical

103TC0700X 62 Psychologist, Clinical
 

Clinical

1041C0700X 80 Licensed Clinical Social Worker
 

Nurse Practitioner

363L00000X 50 Nurse Practitioner
Indicates primary specialty

NPI Profile & details for SUPPORTIVE CARE OF WYOMING LLC

NPI Number 1578413167
LBN Legal business name SUPPORTIVE CARE OF WYOMING LLC
Authorized official RAPHAEL LICHTSCHEIN - (PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 02/02/2026
Last updated 02/02/2026 - About 4 months ago
Identifiers n/a
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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