Provider Demographics
NPI:1215475249
Name:TRILIEGI, ROMANA (LPCC)
Entity type:Individual
Prefix:
First Name:ROMANA
Middle Name:
Last Name:TRILIEGI
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6640 LYNDALE AVE S APT 207P
Mailing Address - Street 2:
Mailing Address - City:RICHFIELD
Mailing Address - State:MN
Mailing Address - Zip Code:55423-2367
Mailing Address - Country:US
Mailing Address - Phone:612-205-3595
Mailing Address - Fax:
Practice Address - Street 1:8401 WAYZATA BLVD
Practice Address - Street 2:SUITE 150
Practice Address - City:GOLDEN VALLEY
Practice Address - State:MN
Practice Address - Zip Code:55426-1343
Practice Address - Country:US
Practice Address - Phone:612-205-3595
Practice Address - Fax:763-544-1008
Is Sole Proprietor?:No
Enumeration Date:2017-02-10
Last Update Date:2017-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN01434101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN1831239003Medicaid