Provider Demographics
NPI:1073081659
Name:ZORETICH, TRISHA A (LCSW)
Entity Type:Individual
Prefix:
First Name:TRISHA
Middle Name:A
Last Name:ZORETICH
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1712 OLYMPIA RD
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33619-4973
Mailing Address - Country:US
Mailing Address - Phone:813-784-1074
Mailing Address - Fax:
Practice Address - Street 1:4902 EISENHOWER BLVD STE 315
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33634-6344
Practice Address - Country:US
Practice Address - Phone:813-252-0913
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-13
Last Update Date:2018-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW157551041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical