Provider Demographics
NPI:1831646967
Name:WOOLERY, TRINITY LOVE (MSW, LICSW, LADC)
Entity Type:Individual
Prefix:
First Name:TRINITY
Middle Name:LOVE
Last Name:WOOLERY
Suffix:
Gender:F
Credentials:MSW, LICSW, LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:595 SELBY AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55102-1730
Mailing Address - Country:US
Mailing Address - Phone:612-234-7122
Mailing Address - Fax:
Practice Address - Street 1:595 SELBY AVE
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55102-1730
Practice Address - Country:US
Practice Address - Phone:612-234-7122
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-07
Last Update Date:2024-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN304954101YA0400X
MN265641041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)