Provider Demographics
NPI:1467036483
Name:ZIEM, TRISHA (LPC)
Entity Type:Individual
Prefix:
First Name:TRISHA
Middle Name:
Last Name:ZIEM
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 1:8336 MONROE RD RM 120
Mailing Address - Street 2:
Mailing Address - City:LAMBERTVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48144-9340
Mailing Address - Country:US
Mailing Address - Phone:734-807-0162
Mailing Address - Fax:888-700-7159
Practice Address - Street 1:8336 MONROE RD RM 120
Practice Address - Street 2:
Practice Address - City:LAMBERTVILLE
Practice Address - State:MI
Practice Address - Zip Code:48144-9340
Practice Address - Country:US
Practice Address - Phone:734-807-0162
Practice Address - Fax:888-700-7159
Is Sole Proprietor?:No
Enumeration Date:2021-05-06
Last Update Date:2021-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401019130101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional