Trinity Behavioral Health, LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C-5832 Issued in MS

Legal business name

TRINITY BEHAVIORAL HEALTH, LLC

Practice address

1618 Pear Orchard PL
Jackson, MS 39211-2206

Phone

(601) 942-1129

NPI assigned

Feb 10, 2014

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Phylandria Hudson, LCSWNPI 1164762076

Title

Owner/Ceo

Phone

(601) 942-1129

Specialties & licenses 3

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Phylandria Lashay Hudson, LCSW

  • Clinical Social Worker
  • Fairfax, VA
  • NPI 1164762076
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1391990400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1391990400000",
    "number": "1023432135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1618 PEAR ORCHARD PL",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392112206",
            "telephone_number": "601-942-1129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1618 PEAR ORCHARD PL",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392112206",
            "telephone_number": "601-942-1129"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRINITY BEHAVIORAL HEALTH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-02-10",
        "last_updated": "2014-02-10",
        "status": "A",
        "authorized_official_last_name": "HUDSON",
        "authorized_official_first_name": "PHYLANDRIA",
        "authorized_official_title_or_position": "OWNER/CEO",
        "authorized_official_telephone_number": "601-942-1129",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "MS",
            "license": "C-5832",
            "primary": true
        },
        {
            "code": "163WP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• I'Eaisha Trevillion
• Dylan Scott Tribolet
• Mary Kay Triggs, CRNA
• Jose Ricardo Trigueros Jovel, MD
• William Bradley Trimble II
• Trinity Emergency Medical Transportation Corporation (Trinity Medical Transportation)
• Trinity Mercy Home Health Care Agency LLC
• Trinity Pediatric Clinic
• Trinity Rehabilitation Inc
• Shakaylia Triplett

• Clinical Social Worker in Jackson, MS
• Providers in Jackson, MS by specialty
• Clinical Social Worker in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.