Provider Demographics
NPI:1972836922
Name:LEVIN, TRINA S (LICSW)
Entity Type:Individual
Prefix:
First Name:TRINA
Middle Name:S
Last Name:LEVIN
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2021 EAST HENNEPIN AVE.
Mailing Address - Street 2:SUITE 100
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55413-1769
Mailing Address - Country:US
Mailing Address - Phone:612-259-1704
Mailing Address - Fax:612-259-1789
Practice Address - Street 1:2021 EAST HENNEPIN AVE.
Practice Address - Street 2:SUITE 100
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55413-1769
Practice Address - Country:US
Practice Address - Phone:612-259-1704
Practice Address - Fax:612-259-1789
Is Sole Proprietor?:No
Enumeration Date:2009-09-09
Last Update Date:2009-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN173521041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical