Provider Demographics
NPI:1568196921
Name:CLEVELAND, LA TRICIA (LMFT-A)
Entity Type:Individual
Prefix:
First Name:LA TRICIA
Middle Name:
Last Name:CLEVELAND
Suffix:
Gender:F
Credentials:LMFT-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4900 AIRPORT PKWY UNIT 401
Mailing Address - Street 2:
Mailing Address - City:ADDISON
Mailing Address - State:TX
Mailing Address - Zip Code:75001-3811
Mailing Address - Country:US
Mailing Address - Phone:214-850-6915
Mailing Address - Fax:
Practice Address - Street 1:4888 DEXTER DR # 300
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-5505
Practice Address - Country:US
Practice Address - Phone:469-717-0662
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-12
Last Update Date:2022-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX204564106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist