Provider Demographics
NPI:1013361880
Name:COOMBS, TRISHA J (LPC)
Entity Type:Individual
Prefix:MS
First Name:TRISHA
Middle Name:J
Last Name:COOMBS
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 1:1120 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BRIDGEPORT
Mailing Address - State:CT
Mailing Address - Zip Code:06604-4404
Mailing Address - Country:US
Mailing Address - Phone:203-368-9755
Mailing Address - Fax:203-368-9760
Practice Address - Street 1:1120 MAIN ST
Practice Address - Street 2:
Practice Address - City:BRIDGEPORT
Practice Address - State:CT
Practice Address - Zip Code:06604-4404
Practice Address - Country:US
Practice Address - Phone:203-368-9755
Practice Address - Fax:203-368-9760
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-19
Last Update Date:2016-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT2890101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional