Provider Demographics
NPI:1457929481
Name:TRINITAS SERVICES
Entity Type:Organization
Organization Name:TRINITAS SERVICES
Other - Org Name:TRINITAS SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:PHILLIP
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:BASS
Authorized Official - Suffix:
Authorized Official - Credentials:MDIV, THM, MA, LCMHC
Authorized Official - Phone:919-210-4627
Mailing Address - Street 1:4070 BARRETT DR
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27609-6604
Mailing Address - Country:US
Mailing Address - Phone:919-283-3137
Mailing Address - Fax:
Practice Address - Street 1:1777 FORDHAM BLVD STE 204
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27514-5885
Practice Address - Country:US
Practice Address - Phone:919-283-3137
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-16
Last Update Date:2024-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty