Provider Demographics
NPI:1003577990
Name:TRENGOVE, SARAH (LPC)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:TRENGOVE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 E RUBY AVE APT A
Mailing Address - Street 2:
Mailing Address - City:PALISADES PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07650-2986
Mailing Address - Country:US
Mailing Address - Phone:201-431-2414
Mailing Address - Fax:
Practice Address - Street 1:224/92 SOI 2A KWAN WIANG MU 3
Practice Address - Street 2:SAN PHAK WAN
Practice Address - City:HANG DONG
Practice Address - State:CHIANG MAI
Practice Address - Zip Code:50230
Practice Address - Country:TH
Practice Address - Phone:201-431-2414
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-04
Last Update Date:2022-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00808400101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional