Provider Demographics
NPI:1316532047
Name:TRINITY CONSULTING & COUNSELING INC
Entity type:Organization
Organization Name:TRINITY CONSULTING & COUNSELING INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KATINA
Authorized Official - Middle Name:JOHNSON-FRY
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:MS, MBA
Authorized Official - Phone:317-492-3871
Mailing Address - Street 1:5170 E 65TH ST STE 107
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46220-4992
Mailing Address - Country:US
Mailing Address - Phone:317-845-8475
Mailing Address - Fax:317-845-8476
Practice Address - Street 1:5170 E 65TH ST STE 107
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46220-4992
Practice Address - Country:US
Practice Address - Phone:317-845-8475
Practice Address - Fax:317-845-8476
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-04
Last Update Date:2021-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200837620AMedicaid