Healthcare Provider Details

I. General information

NPI: 1679231468
Provider Name (Legal Business Name): MRS. TRELISHA LOCHNER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/30/2021
Last Update Date: 06/19/2026
Certification Date: 06/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17805 W CARMEN DR
SURPRISE AZ
85388-1710
US

IV. Provider business mailing address

17805 W CARMEN DR
SURPRISE AZ
85388-1710
US

V. Phone/Fax

Practice location:
  • Phone: 623-738-5696
  • Fax:
Mailing address:
  • Phone: 623-738-5696
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLAC-24218
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: