Provider Demographics
NPI:1992169676
Name:TRINIDAD, CORAL K (LPC)
Entity type:Individual
Prefix:
First Name:CORAL
Middle Name:K
Last Name:TRINIDAD
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2140 MCGEE RD
Mailing Address - Street 2:
Mailing Address - City:SNELLVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30078-2980
Mailing Address - Country:US
Mailing Address - Phone:470-336-8598
Mailing Address - Fax:678-559-0717
Practice Address - Street 1:2140 MCGEE RD
Practice Address - Street 2:
Practice Address - City:SNELLVILLE
Practice Address - State:GA
Practice Address - Zip Code:30078-2980
Practice Address - Country:US
Practice Address - Phone:470-336-8598
Practice Address - Fax:678-559-0717
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-08
Last Update Date:2016-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC007357101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional