Provider Demographics
NPI:1770473662
Name:TREDE, VICTOR
Entity type:Individual
Prefix:
First Name:VICTOR
Middle Name:
Last Name:TREDE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:74 BONNYBANK TER
Mailing Address - Street 2:
Mailing Address - City:SOUTH PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04106-6307
Mailing Address - Country:US
Mailing Address - Phone:617-304-0315
Mailing Address - Fax:
Practice Address - Street 1:535 OCEAN AVE STE 4
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04103-4970
Practice Address - Country:US
Practice Address - Phone:207-370-5389
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-03
Last Update Date:2025-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEMC249001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical