Healthcare Provider Details

I. General information

NPI: 1184741902
Provider Name (Legal Business Name): TRINITY COUNSELING CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/25/2007
Last Update Date: 07/05/2023
Certification Date: 07/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

820 ASBURY DR
MANDEVILLE LA
70471-1842
US

IV. Provider business mailing address

2150 GENERAL PERSHING STREET
MANDEVILLE LA
70448
US

V. Phone/Fax

Practice location:
  • Phone: 985-674-5155
  • Fax: 985-674-5156
Mailing address:
  • Phone: 985-674-5155
  • Fax: 985-674-5156

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License NumberABA 36364795K
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: MS. MICHELLE P. CROWLEY
Title or Position: CEO
Credential: LMSW
Phone: 985-674-5155