Provider Demographics
NPI:1205270972
Name:TREMBLAY, KAREN JULIA (LCSW)
Entity type:Individual
Prefix:MS
First Name:KAREN
Middle Name:JULIA
Last Name:TREMBLAY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37 ARABELLA LN
Mailing Address - Street 2:
Mailing Address - City:CLAYTON
Mailing Address - State:NC
Mailing Address - Zip Code:27520-4984
Mailing Address - Country:US
Mailing Address - Phone:919-389-7535
Mailing Address - Fax:
Practice Address - Street 1:37 ARABELLA LN
Practice Address - Street 2:
Practice Address - City:CLAYTON
Practice Address - State:NC
Practice Address - Zip Code:27520-4984
Practice Address - Country:US
Practice Address - Phone:919-389-7535
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-24
Last Update Date:2013-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0048461041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCC004846OtherLICENSED CLINICAL SOCIAL WORKER