Provider Demographics
NPI:1063284495
Name:NOWAK, TRISHA ANN (LCSW)
Entity type:Individual
Prefix:MRS
First Name:TRISHA
Middle Name:ANN
Last Name:NOWAK
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:TRISHA
Other - Middle Name:ANN
Other - Last Name:STINE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7218 MCLEOD DR
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79602-1362
Mailing Address - Country:US
Mailing Address - Phone:713-287-0506
Mailing Address - Fax:
Practice Address - Street 1:7218 MCLEOD DR
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79602-1362
Practice Address - Country:US
Practice Address - Phone:713-287-0506
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-30
Last Update Date:2023-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX670231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty