Provider Demographics
NPI:1124179312
Name:SACKSCHEWSKY, TRISHA L (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:TRISHA
Middle Name:L
Last Name:SACKSCHEWSKY
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 1:12914 FM 1960 RD W STE F
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77065-5311
Mailing Address - Country:US
Mailing Address - Phone:832-237-3331
Mailing Address - Fax:832-237-4638
Practice Address - Street 1:12914 FM 1960 RD W STE F
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77065-5311
Practice Address - Country:US
Practice Address - Phone:832-237-3331
Practice Address - Fax:832-237-4638
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXS40896104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1039931OtherBCBS GROUP ID #