Provider Demographics
NPI:1548770431
Name:DENNIS, TRICIA FRANCES (LMHC)
Entity Type:Individual
Prefix:
First Name:TRICIA
Middle Name:FRANCES
Last Name:DENNIS
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:TRICIA
Other - Middle Name:FRANCES
Other - Last Name:EXNER-DENNIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMHC
Mailing Address - Street 1:128 GRANT AVE
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:NY
Mailing Address - Zip Code:13021-2153
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:144 GENESEE ST STE 401
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:NY
Practice Address - Zip Code:13021-3511
Practice Address - Country:US
Practice Address - Phone:315-253-8477
Practice Address - Fax:315-253-4727
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-04
Last Update Date:2023-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008190101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY008190-1OtherMENTAL HEALTH