Provider Demographics
NPI:1245678846
Name:ADEMOFE, TRINA M (LICSW)
Entity type:Individual
Prefix:MRS
First Name:TRINA
Middle Name:M
Last Name:ADEMOFE
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:PO BOX 974
Mailing Address - Street 2:
Mailing Address - City:LYNNWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98046-0974
Mailing Address - Country:US
Mailing Address - Phone:206-538-1323
Mailing Address - Fax:
Practice Address - Street 1:7830 196TH ST SW APT 8
Practice Address - Street 2:
Practice Address - City:EDMONDS
Practice Address - State:WA
Practice Address - Zip Code:98026-6530
Practice Address - Country:US
Practice Address - Phone:206-538-1323
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-05
Last Update Date:2023-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW602909041041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical