Trinity Wholistic Healing Services

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

13071 Issued in MD

Legal business name

TRINITY WHOLISTIC HEALING SERVICES

Practice address

1701 Enterprise Rd
Mitchellville, MD 20721-2213

Phone

(301) 442-1990

Fax

(301) 627-1806

NPI assigned

Sep 4, 2009

Organization subpart

No

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

Authorized official

Name

Audra N Gillis, MSW, LICSW

Title

Owner

Phone

(301) 442-1990

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1252022400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1252022400000",
    "number": "1104059328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16314 BOSWELL PL",
            "city": "UPPER MARLBORO",
            "state": "MD",
            "postal_code": "207723286",
            "telephone_number": "301-442-1990",
            "fax_number": "301-627-1806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 ENTERPRISE RD",
            "city": "MITCHELLVILLE",
            "state": "MD",
            "postal_code": "207212213",
            "telephone_number": "301-442-1990",
            "fax_number": "301-627-1806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRINITY WHOLISTIC HEALING SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-04",
        "last_updated": "2009-09-04",
        "status": "A",
        "authorized_official_last_name": "GILLIS",
        "authorized_official_first_name": "AUDRA",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "301-442-1990",
        "authorized_official_credential": "MSW, LICSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "13071",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Mitchellville, MD
• Providers in Mitchellville, MD by specialty
• Clinical Social Worker in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2009; 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.