Healthcare Provider Details

I. General information

NPI: 1043762941
Provider Name (Legal Business Name): TRINITY SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/27/2016
Last Update Date: 10/27/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4401 BROOKS ST NE
WASHINGTON DC
20019-4606
US

IV. Provider business mailing address

5304 N ENGLEWOOD DR
HYATTSVILLE MD
20785-3842
US

V. Phone/Fax

Practice location:
  • Phone: 301-541-7479
  • Fax:
Mailing address:
  • Phone: 240-893-6191
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number21583
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License NumberLC50078113
License Number StateDC
# 3
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number21583
License Number StateMD
# 4
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License NumberLC50078113
License Number StateDC

VIII. Authorized Official

Name: NATALIE MILLIGAN
Title or Position: OWNER
Credential: LICSW, LCSW-C
Phone: 240-893-6191