MEDICARE: LINDSAY TREMBLAY MSC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	26923	FL

General Provider Information

NPI Number	:	1699490946
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LINDSAY TREMBLAY MSC

Provider Business Mailing Address
First Line	:	120 E NEW YORK AVE STE C
Second Line	:
City	:	DELAND
State	:	FL
Zip	:	32724-5527
Country	:	US
Telephone Number	:	386-855-5762
Fax Number	:

Provider Business Practice Location Address
First Line	:	5374 ARDSDALE LN
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32814-6748
Country	:	US
Telephone Number	:	321-888-6806
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/10/2022
Last Update Date	:	10/10/2022

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