Provider Demographics
NPI:1740421254
Name:TRINITY COUNSELING & EDUCATIONAL SERVICES
Entity Type:Organization
Organization Name:TRINITY COUNSELING & EDUCATIONAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MRS
Authorized Official - First Name:TRACY
Authorized Official - Middle Name:DENICE
Authorized Official - Last Name:MCCALL
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:313-778-4729
Mailing Address - Street 1:15122 W CHICAGO ST
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48228-2357
Mailing Address - Country:US
Mailing Address - Phone:313-836-7667
Mailing Address - Fax:313-836-7181
Practice Address - Street 1:15122 W CHICAGO ST
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48228-2357
Practice Address - Country:US
Practice Address - Phone:313-836-7667
Practice Address - Fax:313-836-7181
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-12
Last Update Date:2009-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801066493251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health