Provider Demographics
NPI:1841749553
Name:SAWYER, TREMAINE
Entity Type:Individual
Prefix:
First Name:TREMAINE
Middle Name:
Last Name:SAWYER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 PIEDMONT FOREST COURT
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27703-2935
Mailing Address - Country:US
Mailing Address - Phone:919-939-0573
Mailing Address - Fax:
Practice Address - Street 1:3 PIEDMONT FOREST COURT
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27703-2935
Practice Address - Country:US
Practice Address - Phone:919-939-0573
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-23
Last Update Date:2016-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCCSAC-3013101YA0400X
NCLCAS-22847101YA0400X
101YM0800X
NCP0109421041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health