Provider Demographics
NPI:1861830812
Name:CHAMBERS, TRISHA (LMSW)
Entity Type:Individual
Prefix:
First Name:TRISHA
Middle Name:
Last Name:CHAMBERS
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:TRISHA
Other - Middle Name:
Other - Last Name:SUHADOLNIK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMSW
Mailing Address - Street 1:346 GRAND AVE
Mailing Address - Street 2:
Mailing Address - City:JOHNSON CITY
Mailing Address - State:NY
Mailing Address - Zip Code:13790-2580
Mailing Address - Country:US
Mailing Address - Phone:607-729-8156
Mailing Address - Fax:607-729-3982
Practice Address - Street 1:10 MITCHELL AVE
Practice Address - Street 2:NEW HORIZONS
Practice Address - City:BINGHAMTON
Practice Address - State:NY
Practice Address - Zip Code:13903
Practice Address - Country:US
Practice Address - Phone:607-762-2229
Practice Address - Fax:607-762-2028
Is Sole Proprietor?:No
Enumeration Date:2013-06-12
Last Update Date:2013-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY085679104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker