Provider Demographics
NPI:1861773376
Name:TRAYNHAM FERAGEN, AMY C (LCSW)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:C
Last Name:TRAYNHAM FERAGEN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:C
Other - Last Name:TRAYNHAM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:PO BOX 9658
Mailing Address - Street 2:
Mailing Address - City:HELENA
Mailing Address - State:MT
Mailing Address - Zip Code:59604
Mailing Address - Country:US
Mailing Address - Phone:406-781-3342
Mailing Address - Fax:
Practice Address - Street 1:900 N MONTANA AVE
Practice Address - Street 2:STE B7
Practice Address - City:HELENA
Practice Address - State:MT
Practice Address - Zip Code:59601
Practice Address - Country:US
Practice Address - Phone:406-594-7109
Practice Address - Fax:406-494-1724
Is Sole Proprietor?:No
Enumeration Date:2011-08-30
Last Update Date:2020-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT10231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT1477745370Medicaid