Provider Demographics
NPI:1992988695
Name:METZ, TRISTA ESCOBAR (LICSW)
Entity type:Individual
Prefix:
First Name:TRISTA
Middle Name:ESCOBAR
Last Name:METZ
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:TRISTA
Other - Middle Name:ESCOBAR
Other - Last Name:METZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ISW
Mailing Address - Street 1:26 SMITH ST
Mailing Address - Street 2:
Mailing Address - City:SEEKONK
Mailing Address - State:MA
Mailing Address - Zip Code:02771-6013
Mailing Address - Country:US
Mailing Address - Phone:401-699-2845
Mailing Address - Fax:
Practice Address - Street 1:200 TER HEUN DR
Practice Address - Street 2:
Practice Address - City:FALMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02540-2525
Practice Address - Country:US
Practice Address - Phone:508-540-6550
Practice Address - Fax:508-540-7480
Is Sole Proprietor?:No
Enumeration Date:2007-12-17
Last Update Date:2019-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical