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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

KINTSUGI PSYCHIATRY, LLC
NPI 1306406509
Nurse Practitioner - Psychiatric/Mental Health in Casper, WY

Active since June 19, 2019CLIA 53D2302649 · Waiver
145 S DURBIN ST STE 108, CASPER, WY 82601(307) 333-5757(307) 439-2141 Get Directions Write a Review

NPPES record last updated: July 29, 2026. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jul 29, 2026, May 22, 2020, Nov 6, 2019 and 1 more (4 updates tracked since 2019).

About Kintsugi Psychiatry, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KINTSUGI PSYCHIATRY, LLC (NPI 1306406509) is a healthcare organization registered as a psychiatric/mental health in Casper, Wyoming and active in the NPI registry since June 2019. The organization holds a CLIA Waiver certificate valid through April 11, 2028 and lists Teecee Ann Hailey-fulfer, Owner, as its authorized official.

NPPES Registry Identity

NPI1306406509
Entity TypeOrganization
Primary Taxonomy363LP0808X
Legal Business NameKINTSUGI PSYCHIATRY, LLC
Location Address145 S DURBIN ST STE 108Casper, WY 82601-2566
Mailing Address145 S Durbin St Ste 108Casper, WY 82601-2566 · (307) 333-5757 · Fax (307) 439-2141
Phone(307) 333-5757
Fax(307) 439-2141
Organization SubpartNo
Authorized OfficialTeecee Ann Hailey-fulferOwner · (307) 333-5757
Enumeration DateJune 19, 2019
Last NPPES UpdateJuly 29, 20264 updates tracked since enumeration
NPPES CertifiedJuly 29, 2026
✔ NPI 1306406509 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0808X
Also ListedClinic/Center · Adult Mental HealthTaxonomy 261QM0850X
Also ListedClinic/Center · Adolescent and Children Mental HealthTaxonomy 261QM0855X
145 S DURBIN ST STE 108, Casper, WY 82601
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Other Identifiers 2

Medicaid1306406509WY
Medicaid1093117210WY

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross Blue Shield of Wyoming.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 53D2302649

Kintsugi Psychiatry LLC · Casper, WY
Active · expires Apr 11, 2028
CLIA Number53D2302649
Laboratory TypePhysician Office
Certificate Effective DateApril 12, 2026
Certificate Expiration DateApril 11, 2028
Laboratory DirectorTeecee Hailey-Fulfer
Laboratory Phone(307) 333-5757
Laboratory LocationKintsugi Psychiatry LLC145 South Durbin Street, Suite 108, Casper, WY 82601
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

TEECEE ANN HAILEY-FULFER APRN, PMHNP-BC
Nurse Practitioner (Psychiatric/Mental Health)
145 S DURBIN ST STE 108
CASPER, WY 82601
Natrona County (307) 333-5757

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kintsugi Psychiatry, LLC's NPI number?

The NPI number for Kintsugi Psychiatry, LLC is 1306406509. It was assigned to this organization in the NPPES registry on June 19, 2019.

Where is Kintsugi Psychiatry, LLC located?

Kintsugi Psychiatry, LLC is located at 145 S Durbin St Ste 108, Casper, WY 82601. The listed phone number is (307) 333-5757.

What is Kintsugi Psychiatry, LLC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Does Kintsugi Psychiatry, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 53D2302649) is associated with this NPI, valid through April 11, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Kintsugi Psychiatry, LLC accept?

Health plans from Blue Cross Blue Shield of Wyoming list Kintsugi Psychiatry, LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Kintsugi Psychiatry, LLC was last updated on July 29, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 22 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.