Provider Demographics
NPI:1780766485
Name:TRILOGY SERVICES, INC.
Entity type:Organization
Organization Name:TRILOGY SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MONTY
Authorized Official - Middle Name:G
Authorized Official - Last Name:GRUBB
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:910-686-4300
Mailing Address - Street 1:7741 MARKET ST
Mailing Address - Street 2:SUITE C
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28411-8806
Mailing Address - Country:US
Mailing Address - Phone:910-686-4300
Mailing Address - Fax:910-686-3303
Practice Address - Street 1:7741 MARKET ST
Practice Address - Street 2:SUITE C
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28411-8806
Practice Address - Country:US
Practice Address - Phone:910-686-4300
Practice Address - Fax:910-686-3303
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-20
Last Update Date:2018-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1529103TA0700X, 103TB0200X, 103TM1800X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
No103TA0700XBehavioral Health & Social Service ProvidersPsychologistAdult Development & AgingGroup - Single Specialty
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & BehavioralGroup - Single Specialty
No103TM1800XBehavioral Health & Social Service ProvidersPsychologistIntellectual & Developmental DisabilitiesGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCS-24774OtherUPIN
NC1529OtherPSYCHOLOGIST LICENSE NO.
NC6000492Medicaid
0005009616OtherAETNA
NC0706COtherBC/BS OF NC
NC6000492Medicaid
0005009616OtherAETNA