MEDICARE: SOUTHERN TRINITY THERAPEUTIC SOLUTIONS, LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)
2	1041C0700X	Clinical Social Worker
3	101YM0800X	Mental Health Counselor
4	101Y00000X	Counselor
5	104100000X	Social Worker
6	101YP2500X	Professional Counselor
7	251B00000X	Case Management Agency

General Provider Information

NPI Number	:	1073299541
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOUTHERN TRINITY THERAPEUTIC SOLUTIONS, LLC

Provider Business Mailing Address
First Line	:	PO BOX 764544
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75376-4544
Country	:	US
Telephone Number	:	214-717-7445
Fax Number	:

Provider Business Practice Location Address
First Line	:	4211 CEDAR SPRINGS RD STE 300
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75219-2600
Country	:	US
Telephone Number	:	469-987-3199
Fax Number	:

Authorized Official
Title or Position	:	OWNER/CHIEF EXECUTIVE OFFICER
Name	:	DAPHNE JONES
Credential	:	M.ED., MA., ED.D
Telephone Number	:	469-987-3199

Provider Enumeration Date	:	06/27/2023
Last Update Date	:	09/18/2025

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