Provider Demographics
NPI: | 1619037447 |
---|---|
Name: | TRINITY COUNSELING SERVICES LLC |
Entity Type: | Organization |
Organization Name: | TRINITY COUNSELING SERVICES LLC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | EXECUTIVE DIRECTOR |
Authorized Official - Prefix: | |
Authorized Official - First Name: | TROY |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | BELTON |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 803-741-5598 |
Mailing Address - Street 1: | PO BOX 40105 |
Mailing Address - Street 2: | |
Mailing Address - City: | COLUMBIA |
Mailing Address - State: | SC |
Mailing Address - Zip Code: | 29240-0105 |
Mailing Address - Country: | US |
Mailing Address - Phone: | |
Mailing Address - Fax: | |
Practice Address - Street 1: | 2611 FOREST DR STE 206 |
Practice Address - Street 2: | |
Practice Address - City: | COLUMBIA |
Practice Address - State: | SC |
Practice Address - Zip Code: | 29204-2371 |
Practice Address - Country: | US |
Practice Address - Phone: | 803-741-5598 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2006-12-11 |
Last Update Date: | 2020-08-22 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
SC | 26446 | 2084P0800X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 2084P0800X | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry | Group - Multi-Specialty |