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GARY R ENGEN MSW, LPC

Addiction Substance Use Disorder

Laramie, Wyoming

Provider NPI: 1558347336

Provider Information:
 GARY R ENGEN MSW, LPC
Gender: M
Not Sole Proprietor

Practice Location:
1263 N 15TH ST  LARAMIE, WY 82072 US
Tel: 307-745-8915  Fax: 307-745-8761

Business Mailing Address:
1277 N 15TH ST  LARAMIE, WY 82072 US
Tel: 307-742-6222  Fax: 307-742-9233

Entity Type: Individual

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y101Y00000XBehavioral Health & Social Service Providers
Counselor
WY1134

Other Provider Identifiers:

IssuerNumberStateType
BS312367WY01
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin







ADDICTION JOBS WY - Page 1



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