Healthcare Provider Details

I. General information

NPI: 1942339247
Provider Name (Legal Business Name): TRINITY COLLINS-JUSTIAN LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/04/2007
Last Update Date: 09/26/2025
Certification Date: 09/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19358 DAWNSHIRE DR
BROWNSTOWN MI
48193-8514
US

IV. Provider business mailing address

19358 DAWNSHIRE DR
BROWNSTOWN MI
48193-8514
US

V. Phone/Fax

Practice location:
  • Phone: 173-465-8270
  • Fax:
Mailing address:
  • Phone: 173-465-8270
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number6801084711
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6801084711
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: