Healthcare Provider Details

I. General information

NPI: 1851957765
Provider Name (Legal Business Name): TRINITY EMOTIONAL RESILIENCE SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/15/2019
Last Update Date: 05/15/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

410 FOULK RD STE 200B
WILMINGTON DE
19803-3802
US

IV. Provider business mailing address

410 FOULK RD STE 200B
WILMINGTON DE
19803-3802
US

V. Phone/Fax

Practice location:
  • Phone: 302-762-6675
  • Fax:
Mailing address:
  • Phone: 302-762-6675
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: DENISE HAMPTON
Title or Position: MANAGER
Credential:
Phone: 302-513-4210