Provider Demographics
NPI:1902683444
Name:TREMAIN, ADRIENNE (LAC)
Entity Type:Individual
Prefix:
First Name:ADRIENNE
Middle Name:
Last Name:TREMAIN
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:267 FAIRVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:LONG VALLEY
Mailing Address - State:NJ
Mailing Address - Zip Code:07853-3384
Mailing Address - Country:US
Mailing Address - Phone:862-266-2040
Mailing Address - Fax:
Practice Address - Street 1:259 MAIN ST
Practice Address - Street 2:
Practice Address - City:CHESTER
Practice Address - State:NJ
Practice Address - Zip Code:07930-2528
Practice Address - Country:US
Practice Address - Phone:908-914-2624
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-08
Last Update Date:2023-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37AC00664500101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty