Provider Demographics
NPI:1093401564
Name:DAVIS, TRINITY (CDCA)
Entity Type:Individual
Prefix:
First Name:TRINITY
Middle Name:
Last Name:DAVIS
Suffix:
Gender:F
Credentials:CDCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 GALLIA ST STE 600
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:OH
Mailing Address - Zip Code:45662-4097
Mailing Address - Country:US
Mailing Address - Phone:740-353-4673
Mailing Address - Fax:
Practice Address - Street 1:1431 OFFNERE ST
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:OH
Practice Address - Zip Code:45662-3505
Practice Address - Country:US
Practice Address - Phone:740-353-4673
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-17
Last Update Date:2023-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No171M00000XOther Service ProvidersCase Manager/Care Coordinator