Provider Demographics
NPI:1447955638
Name:NOVAK, TRISHA ANN (LMSW)
Entity type:Individual
Prefix:
First Name:TRISHA
Middle Name:ANN
Last Name:NOVAK
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:TRISHA
Other - Middle Name:ANN
Other - Last Name:PARDINI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LLMSW
Mailing Address - Street 1:1139 E FRONT ST
Mailing Address - Street 2:
Mailing Address - City:TRAVERSE CITY
Mailing Address - State:MI
Mailing Address - Zip Code:49686-2926
Mailing Address - Country:US
Mailing Address - Phone:231-468-6737
Mailing Address - Fax:
Practice Address - Street 1:1139 E FRONT ST
Practice Address - Street 2:
Practice Address - City:TRAVERSE CITY
Practice Address - State:MI
Practice Address - Zip Code:49686-2926
Practice Address - Country:US
Practice Address - Phone:231-468-6737
Practice Address - Fax:231-350-4015
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-05
Last Update Date:2024-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010892761041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical