Healthcare Provider Details

I. General information

NPI: 1245389048
Provider Name (Legal Business Name): JUDITH M. VAPOREAN RNC,MSW,LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/09/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3201 S PROVIDENCE RD SUITE 204
COLUMBIA MO
65203-3622
US

IV. Provider business mailing address

3201 S PROVIDENCE RD SUITE 204
COLUMBIA MO
65203-3622
US

V. Phone/Fax

Practice location:
  • Phone: 573-875-0077
  • Fax: 573-875-0078
Mailing address:
  • Phone: 573-875-0077
  • Fax: 573-875-0078

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number004905
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number093274
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: