Healthcare Provider Details

I. General information

NPI: 1023500824
Provider Name (Legal Business Name): TRUST THERAPEUTICS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/06/2018
Last Update Date: 12/17/2024
Certification Date: 12/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 CAMBRIDGE ST FL 14
BOSTON MA
02114-2509
US

IV. Provider business mailing address

PO BOX 191749
ROXBURY MA
02119-0033
US

V. Phone/Fax

Practice location:
  • Phone: 413-372-8572
  • Fax:
Mailing address:
  • Phone: 413-627-3484
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: LISA LOUISE ROBINSON
Title or Position: LICENSED MENTAL HEALTH COUNSELOR
Credential: LMHC
Phone: 413-627-3484