Provider Demographics
NPI:1386228724
Name:TREAD LIGHTLY PSYCHOTHERAPY LLC
Entity Type:Organization
Organization Name:TREAD LIGHTLY PSYCHOTHERAPY LLC
Other - Org Name:TREAD LIGHTLY PSYCHOTHERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:LICENSED MENTAL HEALTH COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:RENEE
Authorized Official - Middle Name:
Authorized Official - Last Name:FITZPATRICK
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LMHC
Authorized Official - Phone:503-922-6651
Mailing Address - Street 1:2512 E EVERGREEN BLVD # 20
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98661-4323
Mailing Address - Country:US
Mailing Address - Phone:503-922-6651
Mailing Address - Fax:
Practice Address - Street 1:2512 E EVERGREEN BLVD # 20
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98661-4323
Practice Address - Country:US
Practice Address - Phone:631-576-5375
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-11
Last Update Date:2021-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health