Provider Demographics
NPI:1497446074
Name:TRUSTY, JOHN (LGPC)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:
Last Name:TRUSTY
Suffix:
Gender:M
Credentials:LGPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3831 ENVISION TER
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20716-3230
Mailing Address - Country:US
Mailing Address - Phone:202-819-3321
Mailing Address - Fax:
Practice Address - Street 1:3831 ENVISION TER
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20716-3230
Practice Address - Country:US
Practice Address - Phone:202-819-3321
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-16
Last Update Date:2023-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLGPC200001450101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health