Healthcare Provider Details

I. General information

NPI: 1558372490
Provider Name (Legal Business Name): JUDITH C. VOS-FERNEAU MSW, LCPC, OTR/L RYT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/09/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

106 W BROADWAY ST
BUTTE MT
59701-9224
US

IV. Provider business mailing address

T-9 FORT MISSOULA
MISSOULA MT
59804-7202
US

V. Phone/Fax

Practice location:
  • Phone: 406-723-5489
  • Fax: 406-782-4020
Mailing address:
  • Phone: 406-532-8400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number1263
License Number StateMT
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number775
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: