Provider Demographics
NPI:1720532583
Name:TREMITIERE TRAUMA RECOVERY, LLC
Entity Type:Organization
Organization Name:TREMITIERE TRAUMA RECOVERY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:NICOLLE
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:TREMITIERE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:717-855-5377
Mailing Address - Street 1:805 S GEORGE ST
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17403-3189
Mailing Address - Country:US
Mailing Address - Phone:717-855-5377
Mailing Address - Fax:
Practice Address - Street 1:805 S GEORGE ST
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17403-3189
Practice Address - Country:US
Practice Address - Phone:717-855-5377
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-10
Last Update Date:2016-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0174511041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty