Provider Demographics
NPI:1609445246
Name:PERRY, TRISHA R (LGMFT)
Entity Type:Individual
Prefix:
First Name:TRISHA
Middle Name:R
Last Name:PERRY
Suffix:
Gender:F
Credentials:LGMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8515 DARK HAWK CIR
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21045-5626
Mailing Address - Country:US
Mailing Address - Phone:614-266-7576
Mailing Address - Fax:
Practice Address - Street 1:6440 DOBBIN RD STE D
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21045-4770
Practice Address - Country:US
Practice Address - Phone:410-730-2385
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-18
Last Update Date:2021-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLGM827101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health