Provider Demographics
NPI:1871285312
Name:TRELEASE, CAROLINE (LGPC)
Entity type:Individual
Prefix:
First Name:CAROLINE
Middle Name:
Last Name:TRELEASE
Suffix:
Gender:F
Credentials:LGPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:420 CHINQUAPIN ROUND RD
Mailing Address - Street 2:
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-4006
Mailing Address - Country:US
Mailing Address - Phone:410-693-7090
Mailing Address - Fax:
Practice Address - Street 1:420 CHINQUAPIN ROUND RD
Practice Address - Street 2:
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-4006
Practice Address - Country:US
Practice Address - Phone:410-990-1811
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-23
Last Update Date:2023-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLGP13891101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty