Healthcare Provider Details

I. General information

NPI: 1861773376
Provider Name (Legal Business Name): AMY C. TRAYNHAM FERAGEN LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: AMY C. TRAYNHAM LCSW

II. Dates (important events)

Enumeration Date: 08/30/2011
Last Update Date: 11/30/2020
Certification Date: 11/30/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 N MONTANA AVE STE B7
HELENA MT
59601
US

IV. Provider business mailing address

PO BOX 9658
HELENA MT
59604
US

V. Phone/Fax

Practice location:
  • Phone: 406-594-7109
  • Fax: 406-494-1724
Mailing address:
  • Phone: 406-781-3342
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number1023
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: