Healthcare Provider Details

I. General information

NPI: 1609221837
Provider Name (Legal Business Name): TRINA WASHINGTON PLC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/25/2016
Last Update Date: 10/10/2023
Certification Date: 10/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5001 WESTBANK EXPY UNIT 100
MARRERO LA
70072-2954
US

IV. Provider business mailing address

5001 WESTBANK EXPY UNIT 100
MARRERO LA
70072-2954
US

V. Phone/Fax

Practice location:
  • Phone: 504-832-5123
  • Fax:
Mailing address:
  • Phone: 504-832-5123
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number9076
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number9076
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: