Provider Demographics
NPI:1609221837
Name:WASHINGTON, TRINA (PLC)
Entity Type:Individual
Prefix:
First Name:TRINA
Middle Name:
Last Name:WASHINGTON
Suffix:
Gender:F
Credentials:PLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5001 WESTBANK EXPY UNIT 100
Mailing Address - Street 2:
Mailing Address - City:MARRERO
Mailing Address - State:LA
Mailing Address - Zip Code:70072-2954
Mailing Address - Country:US
Mailing Address - Phone:504-832-5123
Mailing Address - Fax:
Practice Address - Street 1:5001 WESTBANK EXPY UNIT 100
Practice Address - Street 2:
Practice Address - City:MARRERO
Practice Address - State:LA
Practice Address - Zip Code:70072-2954
Practice Address - Country:US
Practice Address - Phone:504-832-5123
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-25
Last Update Date:2023-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA9076171M00000X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No171M00000XOther Service ProvidersCase Manager/Care Coordinator