Provider Demographics
NPI:1487013371
Name:OWSLEY, TRISHA (LPCC, LICDC)
Entity Type:Individual
Prefix:
First Name:TRISHA
Middle Name:
Last Name:OWSLEY
Suffix:
Gender:F
Credentials:LPCC, LICDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 134
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:OH
Mailing Address - Zip Code:45779-0134
Mailing Address - Country:US
Mailing Address - Phone:740-247-5463
Mailing Address - Fax:740-212-8445
Practice Address - Street 1:2377 FOURTH STREET
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:OH
Practice Address - Zip Code:45779-0134
Practice Address - Country:US
Practice Address - Phone:740-247-5463
Practice Address - Fax:740-212-8445
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-19
Last Update Date:2021-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHICDC.141052101YA0400X
OHC.1500119101YP2500X
OHE.2102183101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0439139Medicaid