Individual provider Active NPI

Ara Trembly, LPC

  • Professional Counselor
  • Kingsland, GA
National Provider Identifier
1316286289
Registry record updated Feb 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LPC008112 Issued in GA
Practice address
100 Mariners Dr Ste D
Kingsland, GA 31548-6667
Phone
(912) 510-0669
NPI assigned
Feb 12, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 20, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X LPC008112 GA Primary

Addresses

Primary practice location

100 Mariners Dr Ste D
Kingsland, GA 31548-6667

Mailing address

1255 Harrison Point TRL
Amelia Island, FL 32034-5017
Phone (904) 347-5139

Other practice location 1

36 South St
Manasquan, NJ 08736-3440
Phone (732) 223-4673

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260602001780 GA Practitioner - Mental Health Counselor 1850862780 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2006
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1255 Harrison Point TRL
Amelia Island, FL 32034-5017

535 Mack Ave
Kingsley, MI 49649-9220

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LPC008112GAMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
The Samaritan Center at the Jersey Shore Professional Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1360627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613779200000",
    "number": "1316286289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1255 HARRISON POINT TRL",
            "city": "AMELIA ISLAND",
            "state": "FL",
            "postal_code": "320345017",
            "telephone_number": "904-347-5139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MARINERS DR STE D",
            "city": "KINGSLAND",
            "state": "GA",
            "postal_code": "315486667",
            "telephone_number": "912-510-0669"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "36 South St",
            "address_purpose": "LOCATION",
            "city": "Manasquan",
            "state": "NJ",
            "postal_code": "087363440",
            "country_code": "US",
            "telephone_number": "732-223-4673",
            "fax_number": "732-722-7867",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TREMBLY",
        "first_name": "ARA",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-02-12",
        "last_updated": "2021-02-20",
        "certification_date": "2021-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "LPC008112",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingsland, GA

Sources for this page

Verify at the official NPI Registry.