Healthcare Provider Details
I. General information
NPI: 1487519328
Provider Name (Legal Business Name): TRINITY DIVERSFIFIED SOLUTIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/23/2025
Last Update Date: 12/23/2025
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
140 WADSWORTH RD
WADSWORTH OH
44281-1400
US
IV. Provider business mailing address
17100 MILES AVE
CLEVELAND OH
44128-2546
US
V. Phone/Fax
- Phone: 234-426-8260
- Fax: 330-334-2235
- Phone: 234-426-8260
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101YA0400X |
| Taxonomy | Addiction (Substance Use Disorder) Counselor |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 106H00000X |
| Taxonomy | Marriage & Family Therapist |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YP2500X |
| Taxonomy | Professional Counselor |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
DAMION
LASHAWN
BOYD
SR.
Title or Position: COUNSELOR/CEO
Credential: LPC
Phone: 216-647-7910