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General NPI Number Information
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NPI Number | 1568050292
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Entity Type | Organization
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Legal Business Name | TRINITY CONSULTING & COUNSELING, LLC
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Dates
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Enumeration Date | 01/07/2021
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Last Update Date | 01/07/2021
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Provider Practice Location Address
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Address Line | 5170 E 65TH ST STE 107
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City | INDIANAPOLIS
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State | IN
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Zip | 46220-4992
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Country | US
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Telephone | 317-845-8475
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Fax | 317-845-8476
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Provider Business Mailing Address
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Address Line | 5170 E 65TH ST STE 107
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City | INDIANAPOLIS
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State | IN
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Zip | 46220-4992
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Country | US
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Telephone | 317-845-8475
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Fax | 317-845-8476
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Authorized Official
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Title or Position | PRESIDENT/DIRECTOR
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Name | KATINA JOHNSON-FRY SMITH
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Credential | MS, MBA
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Telephone | 317-845-8475
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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