Provider Demographics
NPI:1508571423
Name:MCGANN, TRISHA (PLMHP)
Entity Type:Individual
Prefix:MS
First Name:TRISHA
Middle Name:
Last Name:MCGANN
Suffix:
Gender:F
Credentials:PLMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11963 S 29TH ST
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:NE
Mailing Address - Zip Code:68123-1401
Mailing Address - Country:US
Mailing Address - Phone:402-415-9015
Mailing Address - Fax:
Practice Address - Street 1:1237 GOLDEN GATE DR
Practice Address - Street 2:
Practice Address - City:PAPILLION
Practice Address - State:NE
Practice Address - Zip Code:68046-2837
Practice Address - Country:US
Practice Address - Phone:402-590-2947
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-16
Last Update Date:2023-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE12686101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health