Healthcare Provider Details

I. General information

NPI: 1528807609
Provider Name (Legal Business Name): YICHING CHIU TRENKAMP PLPC,MS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/20/2024
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3616 YOUREE DR
SHREVEPORT LA
71105-2122
US

IV. Provider business mailing address

417 SOPHIA LN
SHREVEPORT LA
71115-2503
US

V. Phone/Fax

Practice location:
  • Phone: 318-779-0104
  • Fax:
Mailing address:
  • Phone: 318-505-6957
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number10128
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number10128
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: