Individual
COREY M INGRAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCADC
Contact information
Practice address
204 HILLCREST AVE, TRENTON, NJ 08618-3410
(609) 508-2173
Mailing address
204 HILLCREST AVE, TRENTON, NJ 08618-3410
(609) 508-2173
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
37LC00332100
NJ
101YA0400X
Addiction (Substance Use Disorder) Counselor
37LC00332100
—
Other
Enumeration date
07/28/2023
Last updated
10/13/2023
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