Provider Demographics
NPI:1134713480
Name:LUNDIN, TRISHA MARIE (LPC)
Entity type:Individual
Prefix:
First Name:TRISHA
Middle Name:MARIE
Last Name:LUNDIN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:TRISHA
Other - Middle Name:MARIE
Other - Last Name:KUEHL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:403 SUMMIT AVE
Mailing Address - Street 2:
Mailing Address - City:EAU CLAIRE
Mailing Address - State:WI
Mailing Address - Zip Code:54701-4805
Mailing Address - Country:US
Mailing Address - Phone:715-255-0125
Mailing Address - Fax:
Practice Address - Street 1:1030 OAK RIDGE DR STE D
Practice Address - Street 2:
Practice Address - City:EAU CLAIRE
Practice Address - State:WI
Practice Address - Zip Code:54701-6257
Practice Address - Country:US
Practice Address - Phone:715-255-0125
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-26
Last Update Date:2021-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI7195-125101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor