| Trinity Life Counseling | |
|
16262 Vixen Rd Stark City MO 64866-7945 | |
| (417) 388-9872 | |
| (888) 310-7328 |
| Full Name | Trinity Life Counseling |
|---|---|
| Speciality | Social Worker |
| Location | 16262 Vixen Rd, Stark City, Missouri |
| Authorized Official Name and Position | Cynthia Lungstrum (PRESIDENT) |
| Authorized Official Contact | 4173889872 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Trinity Life Counseling 16262 Vixen Rd Stark City MO 64866-7945 Ph: (417) 388-9872 | Trinity Life Counseling 16262 Vixen Rd Stark City MO 64866-7945 Ph: (417) 388-9872 |
| NPI Number | 1306164785 |
|---|---|
| Provider Enumeration Date | 05/11/2010 |
| Last Update Date | 06/18/2018 |
| Medicare PECOS PAC ID | 0446389787 |
|---|---|
| Medicare Enrollment ID | O20100526000130 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306164785 | NPI | - | NPPES |
| 497388108 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 2003018404 (Missouri) | Primary |
| Provider Name | Cynthia A Lungstrum |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1427129881 PECOS PAC ID: 6608807086 Enrollment ID: I20050825000408 |
| Provider Name | Doyle Hoth |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1114253721 PECOS PAC ID: 9739451915 Enrollment ID: I20170823001261 |