Provider Demographics
NPI:1932308178
Name:TRENT EVERETT & ASSOCIATES, P.C.
Entity Type:Organization
Organization Name:TRENT EVERETT & ASSOCIATES, P.C.
Other - Org Name:LIFETREK -- PSYCHOLOGICAL, ACADEMIC, AND WELLNESS SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/LICENSED PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:TRENTON
Authorized Official - Middle Name:E
Authorized Official - Last Name:EVERETT
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:832-328-0008
Mailing Address - Street 1:11104 W AIRPORT BLVD
Mailing Address - Street 2:SUITE 135
Mailing Address - City:STAFFORD
Mailing Address - State:TX
Mailing Address - Zip Code:77477-3035
Mailing Address - Country:US
Mailing Address - Phone:832-328-0008
Mailing Address - Fax:
Practice Address - Street 1:11104 W AIRPORT BLVD
Practice Address - Street 2:SUITE 135
Practice Address - City:STAFFORD
Practice Address - State:TX
Practice Address - Zip Code:77477-3035
Practice Address - Country:US
Practice Address - Phone:832-328-0008
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-17
Last Update Date:2007-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Multi-Specialty
No103TA0700XBehavioral Health & Social Service ProvidersPsychologistAdult Development & AgingGroup - Multi-Specialty
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & BehavioralGroup - Multi-Specialty
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & AdolescentGroup - Multi-Specialty
No103TF0000XBehavioral Health & Social Service ProvidersPsychologistFamilyGroup - Multi-Specialty
No103TH0004XBehavioral Health & Social Service ProvidersPsychologistHealthGroup - Multi-Specialty