| Southern Trinity Therapeutic Solutions, Llc | |
|
4211 Cedar Springs Rd Ste 300 Dallas TX 75219-2600 | |
| (469) 987-3199 | |
| Not Available |
| Full Name | Southern Trinity Therapeutic Solutions, Llc |
|---|---|
| Speciality | Case Management |
| Location | 4211 Cedar Springs Rd Ste 300, Dallas, Texas |
| Authorized Official Name and Position | Daphne Jones (OWNER/CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 4699873199 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Southern Trinity Therapeutic Solutions, Llc Po Box 764544 Dallas TX 75376-4544 Ph: (214) 717-7445 | Southern Trinity Therapeutic Solutions, Llc 4211 Cedar Springs Rd Ste 300 Dallas TX 75219-2600 Ph: (469) 987-3199 |
| NPI Number | 1073299541 |
|---|---|
| Provider Enumeration Date | 06/27/2023 |
| Last Update Date | 04/24/2025 |
| Certification Date | 04/24/2025 |
| Medicare PECOS PAC ID | 4284080615 |
|---|---|
| Medicare Enrollment ID | O20231020003036 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073299541 | NPI | - | NPPES |
| Provider Name | Caserea Nikkol Townsend |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1417628777 PECOS PAC ID: 7911346945 Enrollment ID: I20240423002850 |
| Provider Name | Essica Pullam |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1861065765 PECOS PAC ID: 6103282272 Enrollment ID: I20240930000802 |
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