Provider Demographics
NPI:1003414335
Name:HALL, TRINETTE STEPHENSON (LICSW)
Entity Type:Individual
Prefix:MRS
First Name:TRINETTE
Middle Name:STEPHENSON
Last Name:HALL
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29 BELCHER AVE
Mailing Address - Street 2:
Mailing Address - City:BROCKTON
Mailing Address - State:MA
Mailing Address - Zip Code:02301-4103
Mailing Address - Country:US
Mailing Address - Phone:781-774-0273
Mailing Address - Fax:
Practice Address - Street 1:29 BELCHER AVE
Practice Address - Street 2:
Practice Address - City:BROCKTON
Practice Address - State:MA
Practice Address - Zip Code:02301-4103
Practice Address - Country:US
Practice Address - Phone:781-774-0273
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-09
Last Update Date:2020-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1229481041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical