Provider Demographics
NPI:1164936951
Name:WONG, TRINA (LMFT)
Entity type:Individual
Prefix:
First Name:TRINA
Middle Name:
Last Name:WONG
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:65 RIVER BEND RD UNIT D
Mailing Address - Street 2:
Mailing Address - City:STRATFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06614-8406
Mailing Address - Country:US
Mailing Address - Phone:203-671-5836
Mailing Address - Fax:
Practice Address - Street 1:65 RIVER BEND RD UNIT D
Practice Address - Street 2:
Practice Address - City:STRATFORD
Practice Address - State:CT
Practice Address - Zip Code:06614-8406
Practice Address - Country:US
Practice Address - Phone:203-671-5836
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-12-01
Last Update Date:2025-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001955106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT004069985Medicaid