Provider Demographics
NPI:1891381372
Name:TRINITY COUNSELING CENTER OF FLORIDA, INC.
Entity Type:Organization
Organization Name:TRINITY COUNSELING CENTER OF FLORIDA, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:RAE
Authorized Official - Middle Name:
Authorized Official - Last Name:WHITELY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-704-9558
Mailing Address - Street 1:5503 WISHING STAR LN
Mailing Address - Street 2:
Mailing Address - City:GREENACRES
Mailing Address - State:FL
Mailing Address - Zip Code:33463-5930
Mailing Address - Country:US
Mailing Address - Phone:561-523-2286
Mailing Address - Fax:
Practice Address - Street 1:5503 WISHING STAR LN
Practice Address - Street 2:
Practice Address - City:GREENACRES
Practice Address - State:FL
Practice Address - Zip Code:33463-5930
Practice Address - Country:US
Practice Address - Phone:561-523-2286
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-18
Last Update Date:2020-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No251B00000XAgenciesCase Management
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health