Provider Demographics
NPI:1659048676
Name:TRAN, SUZANNE REBECCA (LCADC)
Entity type:Individual
Prefix:
First Name:SUZANNE
Middle Name:REBECCA
Last Name:TRAN
Suffix:
Gender:F
Credentials:LCADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 FOX RUNNE
Mailing Address - Street 2:
Mailing Address - City:ROBBINSVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08691-3647
Mailing Address - Country:US
Mailing Address - Phone:609-477-6802
Mailing Address - Fax:
Practice Address - Street 1:2083 KLOCKNER RD
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:NJ
Practice Address - Zip Code:08690-3415
Practice Address - Country:US
Practice Address - Phone:609-222-4902
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-26
Last Update Date:2021-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37LC00300700101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)