Healthcare Provider Details

I. General information

NPI: 1528521622
Provider Name (Legal Business Name): PAUL RAYMOND TRAHEY JR. LMHC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/08/2019
Last Update Date: 12/27/2024
Certification Date: 12/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4 PINE HILL RD
CROTON ON HUDSON NY
10520-1113
US

IV. Provider business mailing address

4 PINE HILL RD
CROTON ON HUDSON NY
10520-1113
US

V. Phone/Fax

Practice location:
  • Phone: 610-390-5830
  • Fax:
Mailing address:
  • Phone: 610-390-5830
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: