Basic Information
| Provider Information | |||||||||
| NPI: | 1538288766 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | CHILDREN'S ADVOCACY PROJECT INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 350 N ASH ST | ||||||||
| Address2: | |||||||||
| City: | CASPER | ||||||||
| State: | WY | ||||||||
| PostalCode: | 826011808 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3072320159 | ||||||||
| FaxNumber: | 3072320163 | ||||||||
| Practice Location | |||||||||
| Address1: | 350 N ASH ST | ||||||||
| Address2: | |||||||||
| City: | CASPER | ||||||||
| State: | WY | ||||||||
| PostalCode: | 826011808 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3072320159 | ||||||||
| FaxNumber: | 3072320163 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/28/2007 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | MOELLER | ||||||||
| AuthorizedOfficialFirstName: | AMANDA | ||||||||
| AuthorizedOfficialMiddleName: | M | ||||||||
| AuthorizedOfficialTitleorPosition: | PROJECT DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 3072320159 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | X | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Behavioral Health & Social Service Providers | Social Worker | Clinical | 363LP0200X | X | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Pediatrics |
No ID Information.