Provider Demographics
NPI:1417146051
Name:TRIMBLE, TONY LYNN (LMHC)
Entity Type:Individual
Prefix:DR
First Name:TONY
Middle Name:LYNN
Last Name:TRIMBLE
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 N ILLINOIS ST
Mailing Address - Street 2:16TH FLOOR--SOUTH TOWER
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46204-1904
Mailing Address - Country:US
Mailing Address - Phone:317-610-3229
Mailing Address - Fax:317-610-3202
Practice Address - Street 1:201 N ILLINOIS ST
Practice Address - Street 2:16TH FLOOR--SOUTH TOWER
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46204-1904
Practice Address - Country:US
Practice Address - Phone:317-610-3229
Practice Address - Fax:317-610-3202
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-19
Last Update Date:2007-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN39001435A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health