Provider Demographics
NPI:1063271773
Name:TREANOR, ALEXIS AUBREY (LPC, ATR-BC, ACS)
Entity type:Individual
Prefix:
First Name:ALEXIS
Middle Name:AUBREY
Last Name:TREANOR
Suffix:
Gender:F
Credentials:LPC, ATR-BC, ACS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 ANDRE DR
Mailing Address - Street 2:
Mailing Address - City:SUCCASUNNA
Mailing Address - State:NJ
Mailing Address - Zip Code:07876-1802
Mailing Address - Country:US
Mailing Address - Phone:973-943-0222
Mailing Address - Fax:
Practice Address - Street 1:4 ANDRE DR
Practice Address - Street 2:
Practice Address - City:SUCCASUNNA
Practice Address - State:NJ
Practice Address - Zip Code:07876-1802
Practice Address - Country:US
Practice Address - Phone:973-943-0222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-15
Last Update Date:2024-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00636500101YM0800X, 101YP2500X
NJ18-196221700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt Therapist