Provider Demographics
NPI:1992152169
Name:WOMACK, TRESENIA MONICE (LAMFT)
Entity type:Individual
Prefix:MRS
First Name:TRESENIA
Middle Name:MONICE
Last Name:WOMACK
Suffix:
Gender:F
Credentials:LAMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22485 W SOLANO DR
Mailing Address - Street 2:
Mailing Address - City:BUCKEYE
Mailing Address - State:AZ
Mailing Address - Zip Code:85326-7285
Mailing Address - Country:US
Mailing Address - Phone:951-292-8516
Mailing Address - Fax:
Practice Address - Street 1:22485 W SOLANO DR
Practice Address - Street 2:
Practice Address - City:BUCKEYE
Practice Address - State:AZ
Practice Address - Zip Code:85326-5567
Practice Address - Country:US
Practice Address - Phone:951-292-8516
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-18
Last Update Date:2023-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA101YM0800X
106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health