Provider Demographics
NPI:1275723447
Name:GIAMBELLUCA, TRICIA LEE (MHC)
Entity Type:Individual
Prefix:
First Name:TRICIA
Middle Name:LEE
Last Name:GIAMBELLUCA
Suffix:
Gender:F
Credentials:MHC
Other - Prefix:
Other - First Name:TRICIA
Other - Middle Name:LEE
Other - Last Name:RYNSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:52 WOODSTREAM DR
Mailing Address - Street 2:
Mailing Address - City:GRAND ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:14072-1485
Mailing Address - Country:US
Mailing Address - Phone:716-302-4545
Mailing Address - Fax:
Practice Address - Street 1:52 WOODSTREAM DR
Practice Address - Street 2:
Practice Address - City:GRAND ISLAND
Practice Address - State:NY
Practice Address - Zip Code:14072-1485
Practice Address - Country:US
Practice Address - Phone:716-302-4545
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-25
Last Update Date:2023-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004699101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health