Provider Demographics
NPI:1326199894
Name:TRINITY CONSULTING & COUNSELING, INC.
Entity Type:Organization
Organization Name:TRINITY CONSULTING & COUNSELING, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO AND THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:TINA
Authorized Official - Middle Name:N
Authorized Official - Last Name:JOHNSON-FRY SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:MS LMFT LMHC
Authorized Official - Phone:317-492-3871
Mailing Address - Street 1:5170 E 65TH ST
Mailing Address - Street 2:STE 107
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46220-4892
Mailing Address - Country:US
Mailing Address - Phone:317-702-4600
Mailing Address - Fax:317-252-0274
Practice Address - Street 1:5170 E 65TH ST
Practice Address - Street 2:STE. 107
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46220-4892
Practice Address - Country:US
Practice Address - Phone:317-702-4600
Practice Address - Fax:317-252-0274
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-12
Last Update Date:2016-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200837620AMedicaid