Provider Demographics
NPI:1053606723
Name:FOLEY, RODERICK E (MS, LPC)
Entity type:Individual
Prefix:
First Name:RODERICK
Middle Name:E
Last Name:FOLEY
Suffix:
Gender:M
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 246
Mailing Address - Street 2:
Mailing Address - City:RANCHESTER
Mailing Address - State:WY
Mailing Address - Zip Code:82839-0246
Mailing Address - Country:US
Mailing Address - Phone:307-461-2042
Mailing Address - Fax:
Practice Address - Street 1:1111 HWY 345
Practice Address - Street 2:
Practice Address - City:RANCHESTER
Practice Address - State:WY
Practice Address - Zip Code:82839-0246
Practice Address - Country:US
Practice Address - Phone:307-461-2042
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-10
Last Update Date:2020-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X
WYLPC1479101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No171M00000XOther Service ProvidersCase Manager/Care Coordinator