Healthcare Provider Details

I. General information

NPI: 1679326250
Provider Name (Legal Business Name): JOHN E TRENERY PH.D. LPC, LCADC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/11/2024
Last Update Date: 04/25/2024
Certification Date: 04/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

221 RIVER STREET FL 9 STE 3425
HOBOKEN NJ
07030
US

IV. Provider business mailing address

PO BOX 771
HOBOKEN NJ
07030
US

V. Phone/Fax

Practice location:
  • Phone: 201-275-1500
  • Fax: 201-648-2639
Mailing address:
  • Phone: 201-275-1500
  • Fax: 201-648-2639

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number37LC00329400
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number37PC00743400
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: