Provider Demographics
NPI:1770290405
Name:CUPERO, TRISHA LYNN (LCSW)
Entity type:Individual
Prefix:MS
First Name:TRISHA
Middle Name:LYNN
Last Name:CUPERO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:TRISHA
Other - Middle Name:LYNN
Other - Last Name:CUPERO MORGAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1715 W FM 1626 STE 105
Mailing Address - Street 2:
Mailing Address - City:MANCHACA
Mailing Address - State:TX
Mailing Address - Zip Code:78652-3549
Mailing Address - Country:US
Mailing Address - Phone:737-201-3639
Mailing Address - Fax:
Practice Address - Street 1:1715 W FM 1626 STE 105
Practice Address - Street 2:
Practice Address - City:MANCHACA
Practice Address - State:TX
Practice Address - Zip Code:78652-3549
Practice Address - Country:US
Practice Address - Phone:737-222-7369
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-02
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX575211041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical