Provider Demographics
NPI:1881832863
Name:CULVER, TRENT LINCOLN (PSYD)
Entity type:Individual
Prefix:MR
First Name:TRENT
Middle Name:LINCOLN
Last Name:CULVER
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1312 W NORTHWEST HWY
Mailing Address - Street 2:
Mailing Address - City:PALATINE
Mailing Address - State:IL
Mailing Address - Zip Code:60067-1855
Mailing Address - Country:US
Mailing Address - Phone:847-873-1463
Mailing Address - Fax:
Practice Address - Street 1:1312 W NORTHWEST HWY
Practice Address - Street 2:
Practice Address - City:PALATINE
Practice Address - State:IL
Practice Address - Zip Code:60067-1855
Practice Address - Country:US
Practice Address - Phone:847-873-1463
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-28
Last Update Date:2023-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180.007082101YP2500X
IL071.009667103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional