Provider Demographics
NPI:1003265612
Name:TREIRES, JAMES (LPCA)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:TREIRES
Suffix:
Gender:M
Credentials:LPCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5509 CREEDMOOR RD
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27612-6312
Mailing Address - Country:US
Mailing Address - Phone:919-573-6520
Mailing Address - Fax:919-573-6555
Practice Address - Street 1:5509 CREEDMOOR RD
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27612-6312
Practice Address - Country:US
Practice Address - Phone:919-573-6520
Practice Address - Fax:919-573-6555
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-06
Last Update Date:2016-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA10904101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional