Provider Demographics
NPI:1770174492
Name:TRUMBLEY, JOE C (CADC)
Entity type:Individual
Prefix:MR
First Name:JOE
Middle Name:C
Last Name:TRUMBLEY
Suffix:
Gender:M
Credentials:CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:604 LAFAYETTE ST FL 2
Mailing Address - Street 2:
Mailing Address - City:WATERLOO
Mailing Address - State:IA
Mailing Address - Zip Code:50703-4708
Mailing Address - Country:US
Mailing Address - Phone:833-370-0719
Mailing Address - Fax:515-220-2272
Practice Address - Street 1:604 LAFAYETTE ST.
Practice Address - Street 2:SECOND FLOOR
Practice Address - City:WATERLOO
Practice Address - State:IA
Practice Address - Zip Code:50703-4708
Practice Address - Country:US
Practice Address - Phone:833-370-0719
Practice Address - Fax:515-220-2272
Is Sole Proprietor?:No
Enumeration Date:2021-01-27
Last Update Date:2021-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAT20022101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)