Provider Demographics
NPI:1558000125
Name:WURST, TRINA LOU BROWN (MSW)
Entity Type:Individual
Prefix:
First Name:TRINA
Middle Name:LOU BROWN
Last Name:WURST
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:TRINA
Other - Middle Name:LB
Other - Last Name:WURST
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSW
Mailing Address - Street 1:3104 LEHIGH CT
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46268-1320
Mailing Address - Country:US
Mailing Address - Phone:317-870-1101
Mailing Address - Fax:
Practice Address - Street 1:5638 PROFESSIONAL CIR
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46241-5042
Practice Address - Country:US
Practice Address - Phone:888-714-1927
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-01
Last Update Date:2022-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker