Provider Demographics
NPI:1629727581
Name:LOGGINS, TRENEL LEVETTE (LMSW)
Entity Type:Individual
Prefix:
First Name:TRENEL
Middle Name:LEVETTE
Last Name:LOGGINS
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10550 W MCDOWELL RD
Mailing Address - Street 2:
Mailing Address - City:AVONDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85392-4864
Mailing Address - Country:US
Mailing Address - Phone:480-418-4367
Mailing Address - Fax:
Practice Address - Street 1:10550 W MCDOWELL RD
Practice Address - Street 2:
Practice Address - City:AVONDALE
Practice Address - State:AZ
Practice Address - Zip Code:85392-4864
Practice Address - Country:US
Practice Address - Phone:480-418-4267
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-19
Last Update Date:2022-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246YC3301XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Health InformationCoding Specialist, Hospital BasedGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZNAMedicaid