Healthcare Provider Details

I. General information

NPI: 1952047193
Provider Name (Legal Business Name): TRINITY HEALTH GROUP, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/10/2022
Last Update Date: 05/29/2024
Certification Date: 05/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 RIVER DR
IRVINE KY
40336-1118
US

IV. Provider business mailing address

110 RIVER DR
IRVINE KY
40336-1118
US

V. Phone/Fax

Practice location:
  • Phone: 606-614-8081
  • Fax:
Mailing address:
  • Phone: 606-614-8081
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MRS. TONYA GAYLE LUNSFORD
Title or Position: OWNER/OPERATOR
Credential: LPCC
Phone: 859-779-3700