Provider Demographics
NPI:1962104414
Name:BOLFING, TRINA RACHAEL (LMFT-A, LPC-A)
Entity type:Individual
Prefix:
First Name:TRINA
Middle Name:RACHAEL
Last Name:BOLFING
Suffix:
Gender:F
Credentials:LMFT-A, LPC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2600 PENNY LN APT 113
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78757-7602
Mailing Address - Country:US
Mailing Address - Phone:512-537-6353
Mailing Address - Fax:
Practice Address - Street 1:4202 SPICEWOOD SPRINGS RD STE 116
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78759-8621
Practice Address - Country:US
Practice Address - Phone:512-537-6353
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-20
Last Update Date:2024-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX204903106H00000X
TX91900101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health