Provider Demographics
NPI:1699490946
Name:TREMBLAY, LINDSAY (MSC)
Entity type:Individual
Prefix:
First Name:LINDSAY
Middle Name:
Last Name:TREMBLAY
Suffix:
Gender:F
Credentials:MSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 E NEW YORK AVE STE C
Mailing Address - Street 2:
Mailing Address - City:DELAND
Mailing Address - State:FL
Mailing Address - Zip Code:32724-5527
Mailing Address - Country:US
Mailing Address - Phone:386-855-5762
Mailing Address - Fax:
Practice Address - Street 1:5374 ARDSDALE LN
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32814-6748
Practice Address - Country:US
Practice Address - Phone:321-888-6806
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-10
Last Update Date:2022-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL26923101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health