Provider Demographics
NPI:1467225060
Name:WILSON, TRINITY SHALOM (LPC-A)
Entity Type:Individual
Prefix:
First Name:TRINITY
Middle Name:SHALOM
Last Name:WILSON
Suffix:
Gender:F
Credentials:LPC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2264 CATHERINE LN
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75071-2455
Mailing Address - Country:US
Mailing Address - Phone:214-223-4708
Mailing Address - Fax:
Practice Address - Street 1:4500 ELDORADO PKWY
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75070-5757
Practice Address - Country:US
Practice Address - Phone:972-841-1731
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-06
Last Update Date:2023-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX93029101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional