Provider Demographics
NPI:1609159870
Name:TRINITY LIFE COUNSELING, PLLC
Entity Type:Organization
Organization Name:TRINITY LIFE COUNSELING, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DOROTHY
Authorized Official - Middle Name:F
Authorized Official - Last Name:NICHOLS
Authorized Official - Suffix:
Authorized Official - Credentials:CERTIFICATE
Authorized Official - Phone:901-832-0236
Mailing Address - Street 1:4358 RHODES AVE
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38111-8155
Mailing Address - Country:US
Mailing Address - Phone:901-832-0236
Mailing Address - Fax:901-590-3807
Practice Address - Street 1:4358 RHODES AVE
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38111-8155
Practice Address - Country:US
Practice Address - Phone:901-832-0236
Practice Address - Fax:901-590-3807
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-23
Last Update Date:2011-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251B00000XAgenciesCase Management