NPIMap

Organization Active NPI

Trinity Counseling Center, LLC

  • Mental Health Counselor
  • Medford, OR
National Provider Identifier
1427209378
Registry record updated Mar 28, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
TRINITY COUNSELING CENTER, LLC
Practice address
815 E Jackson St
Medford, OR 97504-6713
Phone
(541) 245-2787
Fax
(541) 899-3243
NPI assigned
Oct 8, 2008
Last updated
Mar 28, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2012

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

Authorized official

Name
Mr. Gabriel Joel McCoy, MS, MFTNPI 1417168121
Title
Owner/Member
Phone
(541) 245-2787

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X NU Primary

Addresses

Primary practice location

815 E Jackson St
Medford, OR 97504-6713

Mailing address

815 E Jackson St
Medford, OR 97504-6713
Phone (541) 245-2787

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240104000146 OR Part B Supplier - Clinic/Group Practice 7113378159 Receives reassigned benefits from 9 practitioners
Practice locations: Medford, OR

National Provider Directory

National Provider Directory

Locations

815 E Jackson St
Medford, OR 97504
Phone (541) 245-2787

Practitioners & affiliated clinicians

Practitioners 17

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.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1223424000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1332892800000",
    "number": "1427209378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "815 E JACKSON ST",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975046713",
            "telephone_number": "541-245-2787",
            "fax_number": "541-899-3243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "815 E JACKSON ST",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975046713",
            "telephone_number": "541-245-2787",
            "fax_number": "541-899-3243"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRINITY COUNSELING CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-08",
        "last_updated": "2012-03-28",
        "status": "A",
        "authorized_official_last_name": "MCCOY",
        "authorized_official_first_name": "GABRIEL",
        "authorized_official_middle_name": "JOEL",
        "authorized_official_title_or_position": "OWNER/MEMBER",
        "authorized_official_telephone_number": "541-245-2787",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MS, MFT"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Medford, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.