Provider Demographics
NPI:1326535469
Name:GALE, TRINA L (LPC, NCC)
Entity Type:Individual
Prefix:
First Name:TRINA
Middle Name:L
Last Name:GALE
Suffix:
Gender:F
Credentials:LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7730 CRANE RD
Mailing Address - Street 2:
Mailing Address - City:YPSILANTI
Mailing Address - State:MI
Mailing Address - Zip Code:48197-9391
Mailing Address - Country:US
Mailing Address - Phone:734-652-6012
Mailing Address - Fax:
Practice Address - Street 1:52 E MAIN ST STE 1A
Practice Address - Street 2:
Practice Address - City:MILAN
Practice Address - State:MI
Practice Address - Zip Code:48160-1247
Practice Address - Country:US
Practice Address - Phone:734-508-6140
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-14
Last Update Date:2018-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401013975101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional