| The Trinity Integrative Holistic Medicine & Counseling Services Llc | |
|
917 Lipscomb St Apt D Fort Worth TX 76104-3125 | |
| (817) 829-1214 | |
| Not Available |
| Full Name | The Trinity Integrative Holistic Medicine & Counseling Services Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 917 Lipscomb St Apt D, Fort Worth, Texas |
| Authorized Official Name and Position | Vanna T Camponovo (FOUNDER, OWNER /CEO) |
| Authorized Official Contact | 8178291214 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| The Trinity Integrative Holistic Medicine & Counseling Services Llc 917 Lipscomb St Apt D Fort Worth TX 76104-3125 Ph: (817) 829-1214 | The Trinity Integrative Holistic Medicine & Counseling Services Llc 917 Lipscomb St Apt D Fort Worth TX 76104-3125 Ph: (817) 829-1214 |
| NPI Number | 1467137026 |
|---|---|
| Provider Enumeration Date | 06/20/2023 |
| Last Update Date | 06/20/2023 |
| Certification Date | 06/20/2023 |
| Medicare PECOS PAC ID | 2961926605 |
|---|---|
| Medicare Enrollment ID | O20250403002812 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467137026 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
| Provider Name | Vantranique T Camponovo Hughes |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1013622729 PECOS PAC ID: 8325562051 Enrollment ID: I20250428003434 |
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