MEDICARE: TRINITY S. GRIFFIN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst	1-23-67486	CO

General Provider Information

NPI Number	:	1063023695
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TRINITY S. GRIFFIN

Provider Business Mailing Address
First Line	:	1272 BOND ST STE 100
Second Line	:
City	:	NAPERVILLE
State	:	IL
Zip	:	60563-3084
Country	:	US
Telephone Number	:	800-345-0448
Fax Number	:

Provider Business Practice Location Address
First Line	:	1079 SPACE CENTER DR UNIT 140
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80915-3612
Country	:	US
Telephone Number	:	800-345-0448
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/17/2020
Last Update Date	:	02/26/2026

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