Provider Demographics
| NPI: | 1619037447 |
|---|---|
| Name: | TRINITY COUNSELING SERVICES LLC |
| Entity type: | Organization |
| Organization Name: | TRINITY COUNSELING SERVICES LLC |
| Other - Org Name: | |
| Other - Org Type: | |
| Authorized Official - Title/Position: | EXECUTIVE DIRECTOR |
| Authorized Official - Prefix: | |
| Authorized Official - First Name: | TROY |
| Authorized Official - Middle Name: | |
| Authorized Official - Last Name: | BELTON |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | |
| Authorized Official - Phone: | 803-741-5598 |
| Mailing Address - Street 1: | PO BOX 40105 |
| Mailing Address - Street 2: | |
| Mailing Address - City: | COLUMBIA |
| Mailing Address - State: | SC |
| Mailing Address - Zip Code: | 29240-0105 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | |
| Mailing Address - Fax: | |
| Practice Address - Street 1: | 2611 FOREST DR STE 206 |
| Practice Address - Street 2: | |
| Practice Address - City: | COLUMBIA |
| Practice Address - State: | SC |
| Practice Address - Zip Code: | 29204-2371 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 803-741-5598 |
| Practice Address - Fax: | |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | No |
| Parent Organization LBN: | |
| Parent Organization TIN: | |
| Enumeration Date: | 2006-12-11 |
| Last Update Date: | 2020-08-22 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Licenses
| State | License ID | Taxonomies |
|---|---|---|
| SC | 26446 | 2084P0800X |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization | Group |
|---|---|---|---|---|---|
| Yes | 2084P0800X | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry | Group - Multi-Specialty |