Healthcare Provider Details

I. General information

NPI: 1306907167
Provider Name (Legal Business Name): SARAH LEA TREMBLAY LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MRS. SARAH LEA KERNS

II. Dates (important events)

Enumeration Date: 12/13/2006
Last Update Date: 09/18/2022
Certification Date: 09/18/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3702 178TH ST E
TACOMA WA
98446-2844
US

IV. Provider business mailing address

PO BOX 76
SPANAWAY WA
98387-0076
US

V. Phone/Fax

Practice location:
  • Phone: 253-285-0606
  • Fax:
Mailing address:
  • Phone: 253-285-0606
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberRC00050491
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License NumberAB60809303
License Number StateWA
# 3
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLH60895241
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: