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General NPI Number Information
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NPI Number | 1346673274
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Entity Type | Individual
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Provider Name | ANTIONE J TRENT LCSW, PA
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Gender | Male
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Dates
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Enumeration Date | 08/14/2013
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Last Update Date | 08/05/2025
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Provider Practice Location Address
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Address Line | 615 SHIPYARD BLVD
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City | WILMINGTON
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State | NC
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Zip | 28412-6431
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Country | US
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Telephone | 910-343-0145
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Fax |
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Provider Business Mailing Address
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Address Line | 615 SHIPYARD BLVD
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City | WILMINGTON
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State | NC
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Zip | 28412-6431
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Country | US
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Telephone | 910-343-0145
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Fax | 910-341-5779
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 6801095650
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 0010-15597
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License Number State | NC
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