Provider Demographics
NPI:1386856086
Name:TRELOAR, KATHLEEN AMIE (LICSW)
Entity type:Individual
Prefix:MRS
First Name:KATHLEEN
Middle Name:AMIE
Last Name:TRELOAR
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:475 KILVERT ST STE 310
Mailing Address - Street 2:
Mailing Address - City:WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02886-1360
Mailing Address - Country:US
Mailing Address - Phone:401-603-9925
Mailing Address - Fax:855-843-5562
Practice Address - Street 1:475 KILVERT ST STE 310
Practice Address - Street 2:
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02886-1360
Practice Address - Country:US
Practice Address - Phone:401-603-9925
Practice Address - Fax:855-843-5562
Is Sole Proprietor?:No
Enumeration Date:2007-05-04
Last Update Date:2015-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIISW016591041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical