Provider Demographics
NPI:1942076435
Name:WILLIAMS, TRINA (PLPC 10043)
Entity Type:Individual
Prefix:
First Name:TRINA
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:PLPC 10043
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 MAPLE AVE
Mailing Address - Street 2:
Mailing Address - City:HOUMA
Mailing Address - State:LA
Mailing Address - Zip Code:70364-3148
Mailing Address - Country:US
Mailing Address - Phone:225-284-6297
Mailing Address - Fax:
Practice Address - Street 1:8326 MAIN ST
Practice Address - Street 2:
Practice Address - City:HOUMA
Practice Address - State:LA
Practice Address - Zip Code:70363-4871
Practice Address - Country:US
Practice Address - Phone:225-284-6297
Practice Address - Fax:985-790-7151
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-27
Last Update Date:2024-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPLC10043101Y00000X, 101YA0400X, 101YM0800X, 106H00000X, 171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist