Provider Demographics
NPI:1730655010
Name:TREHAN, JYOTSNA GUPTA (LPC - INTERN)
Entity Type:Individual
Prefix:
First Name:JYOTSNA
Middle Name:GUPTA
Last Name:TREHAN
Suffix:
Gender:F
Credentials:LPC - INTERN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 CARE CIR
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79124-2118
Mailing Address - Country:US
Mailing Address - Phone:806-353-7417
Mailing Address - Fax:806-353-4007
Practice Address - Street 1:12 CARE CIR
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79124-2118
Practice Address - Country:US
Practice Address - Phone:806-353-7417
Practice Address - Fax:806-353-4007
Is Sole Proprietor?:No
Enumeration Date:2018-10-15
Last Update Date:2018-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX80638101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor