Healthcare Provider Details

I. General information

NPI: 1457155624
Provider Name (Legal Business Name): TRINITY CHERCHIO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: TRINITY GRIMORD

II. Dates (important events)

Enumeration Date: 04/04/2025
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date: 07/07/2026
Reactivation Date: 09/03/2026

III. Provider practice location address

1036 SAINT NICHOLAS DR UNIT 102
WALDORF MD
20603-4758
US

IV. Provider business mailing address

1036 SAINT NICHOLAS DR UNIT 102
WALDORF MD
20603-4758
US

V. Phone/Fax

Practice location:
  • Phone: 410-934-0580
  • Fax:
Mailing address:
  • Phone: 410-934-0580
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberLGP17908
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: