Roberta (Bobbie) Jeanne Wenderoth, MA, LCPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

1276-LCPC Issued in MT

Practice address

1048 Burlington Ave
Suite 100
Missoula, MT 59801-5683

Phone

(406) 207-3342

Fax

(406) 721-3394

NPI assigned

Feb 9, 2007

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1689715906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3624 SOUTH AVE W",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598046310",
            "telephone_number": "406-207-3342",
            "fax_number": "406-721-3394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1048 BURLINGTON AVE",
            "address_2": "SUITE 100",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598015683",
            "telephone_number": "406-207-3342",
            "fax_number": "406-721-3394"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WENDEROTH",
        "first_name": "ROBERTA (BOBBIE)",
        "middle_name": "JEANNE",
        "credential": "MA, LCPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-09",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MT",
            "license": "1276-LCPC",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS BLUESHIELD OF M",
            "identifier": "743580",
            "state": "MT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0033761",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Professional Counselor in Missoula, MT
• Providers in Missoula, MT by specialty
• Professional Counselor in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.