Healthcare Provider Details

I. General information

NPI: 1780766485
Provider Name (Legal Business Name): TRILOGY SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/20/2006
Last Update Date: 06/21/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7741 MARKET ST SUITE C
WILMINGTON NC
28411-8806
US

IV. Provider business mailing address

7741 MARKET ST SUITE C
WILMINGTON NC
28411-8806
US

V. Phone/Fax

Practice location:
  • Phone: 910-686-4300
  • Fax: 910-686-3303
Mailing address:
  • Phone: 910-686-4300
  • Fax: 910-686-3303

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TA0700X
TaxonomyAdult Development & Aging Psychologist
License Number1529
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License Number1529
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code103TM1800X
TaxonomyIntellectual & Developmental Disabilities Psychologist
License Number1529
License Number StateNC
# 4
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number1529
License Number StateNC

VIII. Authorized Official

Name: DR. MONTY G. GRUBB
Title or Position: PSYCHOLOGIST/PRESIDENT
Credential: PHD
Phone: 910-686-4300