Provider Demographics
NPI:1306907167
Name:TREMBLAY, SARAH LEA (LMHC)
Entity type:Individual
Prefix:MS
First Name:SARAH
Middle Name:LEA
Last Name:TREMBLAY
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:MRS
Other - First Name:SARAH
Other - Middle Name:LEA
Other - Last Name:KERNS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 76
Mailing Address - Street 2:
Mailing Address - City:SPANAWAY
Mailing Address - State:WA
Mailing Address - Zip Code:98387-0076
Mailing Address - Country:US
Mailing Address - Phone:253-285-0606
Mailing Address - Fax:
Practice Address - Street 1:3702 178TH ST E
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98446-2844
Practice Address - Country:US
Practice Address - Phone:253-285-0606
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-13
Last Update Date:2022-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARC00050491101YP2500X
WAAB60809303106E00000X
WALH60895241101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst