Individual ProviderJennifer ViciedoCounselorBehavioral Health & Social Service ProvidersPractice Address2050 Fairway Dr, Suite 111, Bozeman, MT 59715-5806(406) 570-3547PECOS EnrollmentBased on the most recent information from CMS, provider Jennifer Viciedo does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1821364860Provider TypeIndividualFull NameViciedo, JenniferTitleMs.CredentialM.S., LCPCGenderFemaleSole ProprietorYesEnumeration Date3/23/2012Last Updated9/4/2015Contact InformationPractice LocationPractice Address2050 Fairway Dr, Suite 111, Bozeman, MT 59715-5806Phone(406) 570-3547FaxUnlisted FaxMailing LocationMailing Address424 N Wallace Ave, Bozeman, MT 59715-3756Phone(406) 570-3547FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode101YP2500XPrimaryDescriptionCounselorBehavioral Health & Social Service ProvidersLicense2174 LCPCMontanaCode101Y00000XDescriptionCounselorBehavioral Health & Social Service ProvidersLicense2174 LCPCMontanaCode101YM0800XDescriptionCounselorBehavioral Health & Social Service ProvidersLicense2174 LCPCMontana