Provider Demographics
NPI:1003451303
Name:SCROGGS, TRINITY ALISE (LPC)
Entity type:Individual
Prefix:
First Name:TRINITY
Middle Name:ALISE
Last Name:SCROGGS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:TRINITY
Other - Middle Name:ALISE
Other - Last Name:MOSES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4521 SIERRA RICA RD
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80911-3893
Mailing Address - Country:US
Mailing Address - Phone:719-760-9632
Mailing Address - Fax:
Practice Address - Street 1:4521 SIERRA RICA RD
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80911-3893
Practice Address - Country:US
Practice Address - Phone:719-760-9632
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-10
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPC.0017405101Y00000X
101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor