Provider Demographics
NPI:1699009829
Name:SANTOS, TRINICA A (LICSW)
Entity Type:Individual
Prefix:
First Name:TRINICA
Middle Name:A
Last Name:SANTOS
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:TRINICA
Other - Middle Name:
Other - Last Name:NAUMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BS
Mailing Address - Street 1:205 W GROVE ST
Mailing Address - Street 2:
Mailing Address - City:MIDDLEBORO
Mailing Address - State:MA
Mailing Address - Zip Code:02346-1462
Mailing Address - Country:US
Mailing Address - Phone:508-927-1955
Mailing Address - Fax:
Practice Address - Street 1:205 W GROVE ST
Practice Address - Street 2:
Practice Address - City:MIDDLEBORO
Practice Address - State:MA
Practice Address - Zip Code:02346-1462
Practice Address - Country:US
Practice Address - Phone:508-927-1955
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-09-21
Last Update Date:2020-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1209111041C0700X
103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical