Provider Demographics
NPI:1376741637
Name:O'CONNELL, TRISHA LYNNE (LMHC)
Entity Type:Individual
Prefix:MRS
First Name:TRISHA
Middle Name:LYNNE
Last Name:O'CONNELL
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:799 W BOYLSTON ST
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01606-3071
Mailing Address - Country:US
Mailing Address - Phone:508-414-0677
Mailing Address - Fax:508-856-7247
Practice Address - Street 1:799 W BOYLSTON ST
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01606-3071
Practice Address - Country:US
Practice Address - Phone:508-414-0677
Practice Address - Fax:508-856-7247
Is Sole Proprietor?:No
Enumeration Date:2007-07-10
Last Update Date:2013-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MALMHC 5540101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health