MEDICARE: DR. TONY LYNN TRIMBLE LMHC

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	101YM0800X	Mental Health Counselor	39001435A	IN

General Provider Information

NPI Number	:	1417146051
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TONY LYNN TRIMBLE LMHC

Provider Business Mailing Address
First Line	:	201 N ILLINOIS ST
Second Line	:	16TH FLOOR--SOUTH TOWER
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46204-1904
Country	:	US
Telephone Number	:	317-610-3229
Fax Number	:	317-610-3202

Provider Business Practice Location Address
First Line	:	201 N ILLINOIS ST
Second Line	:	16TH FLOOR--SOUTH TOWER
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46204-1904
Country	:	US
Telephone Number	:	317-610-3229
Fax Number	:	317-610-3202

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

Provider Enumeration Date	:	10/19/2007
Last Update Date	:	10/19/2007

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