Provider Demographics
NPI:1942339247
Name:COLLINS-JUSTIAN, TRINITY (LMSW)
Entity Type:Individual
Prefix:MRS
First Name:TRINITY
Middle Name:
Last Name:COLLINS-JUSTIAN
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19358 DAWNSHIRE DR
Mailing Address - Street 2:
Mailing Address - City:BROWNSTOWN
Mailing Address - State:MI
Mailing Address - Zip Code:48193-8514
Mailing Address - Country:US
Mailing Address - Phone:173-465-8270
Mailing Address - Fax:
Practice Address - Street 1:19358 DAWNSHIRE DR
Practice Address - Street 2:
Practice Address - City:BROWNSTOWN
Practice Address - State:MI
Practice Address - Zip Code:48193-8514
Practice Address - Country:US
Practice Address - Phone:173-465-8270
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-04
Last Update Date:2024-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801084711104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker