Provider Demographics
NPI:1528212370
Name:LETHCOE, TRICIA (LMFT, CATC)
Entity Type:Individual
Prefix:
First Name:TRICIA
Middle Name:
Last Name:LETHCOE
Suffix:
Gender:F
Credentials:LMFT, CATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30101 AGOURA CT
Mailing Address - Street 2:SUITE 204
Mailing Address - City:AGOURA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91301-4300
Mailing Address - Country:US
Mailing Address - Phone:818-926-8737
Mailing Address - Fax:
Practice Address - Street 1:30101 AGOURA CT
Practice Address - Street 2:SUITE 204
Practice Address - City:AGOURA HILLS
Practice Address - State:CA
Practice Address - Zip Code:91301-4300
Practice Address - Country:US
Practice Address - Phone:818-926-8737
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-06
Last Update Date:2014-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA040978101YA0400X
CALMFT53473106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)