Provider Demographics
NPI:1124289939
Name:WARRENVANHORN, TRISHA LEIGH (LCSW)
Entity type:Individual
Prefix:MRS
First Name:TRISHA
Middle Name:LEIGH
Last Name:WARRENVANHORN
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Gender:F
Credentials:LCSW
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Mailing Address - Street 1:100 CAMPUS DRIVE UNIT 110
Mailing Address - Street 2:MAINE MEDICAL CENTER SEARBOROUGH OUTPATIENT CLINICS
Mailing Address - City:SEARBOROUGH
Mailing Address - State:ME
Mailing Address - Zip Code:04074
Mailing Address - Country:US
Mailing Address - Phone:207-885-8565
Mailing Address - Fax:207-885-8595
Practice Address - Street 1:100 CAMPUS DRIVE UNIT 110
Practice Address - Street 2:MAINE MEDICAL CENTER SEARBOROUGH OUTPATIENT CLINICS
Practice Address - City:SEARBOROUGH
Practice Address - State:ME
Practice Address - Zip Code:04074
Practice Address - Country:US
Practice Address - Phone:207-885-8565
Practice Address - Fax:207-885-8595
Is Sole Proprietor?:No
Enumeration Date:2008-06-24
Last Update Date:2009-03-19
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Provider Licenses
StateLicense IDTaxonomies
MELC53431041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME000846701Medicare PIN