Provider Demographics
NPI:1760233266
Name:TRILOGY COUNSELING SERVICES, LLC
Entity Type:Organization
Organization Name:TRILOGY COUNSELING SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CONTRACTOR AND CREDENTIALING
Authorized Official - Prefix:
Authorized Official - First Name:DAWN
Authorized Official - Middle Name:M
Authorized Official - Last Name:LIBERSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:414-426-8910
Mailing Address - Street 1:1245 CHEYENNE AVE STE 104
Mailing Address - Street 2:
Mailing Address - City:GRAFTON
Mailing Address - State:WI
Mailing Address - Zip Code:53024-9323
Mailing Address - Country:US
Mailing Address - Phone:262-618-2832
Mailing Address - Fax:262-293-9777
Practice Address - Street 1:1245 CHEYENNE AVE STE 104
Practice Address - Street 2:
Practice Address - City:GRAFTON
Practice Address - State:WI
Practice Address - Zip Code:53024-9323
Practice Address - Country:US
Practice Address - Phone:262-618-2832
Practice Address - Fax:262-293-9777
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-01
Last Update Date:2024-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty