Provider Demographics
NPI:1316470891
Name:CAVINS, TRISHA ANNETTE (LPC)
Entity type:Individual
Prefix:
First Name:TRISHA
Middle Name:ANNETTE
Last Name:CAVINS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5822 SMOKE GLASS TRL
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75252-2351
Mailing Address - Country:US
Mailing Address - Phone:214-697-5618
Mailing Address - Fax:972-934-0301
Practice Address - Street 1:6350 LBJ FWY STE 252
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75240-6402
Practice Address - Country:US
Practice Address - Phone:214-697-5618
Practice Address - Fax:972-934-0301
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-11
Last Update Date:2017-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX15897101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional