Provider Demographics
NPI:1174388417
Name:TRINITY WELLNESS GROUP LLC
Entity type:Organization
Organization Name:TRINITY WELLNESS GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ANITRA
Authorized Official - Middle Name:
Authorized Official - Last Name:PAYNE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW-C, LICSW
Authorized Official - Phone:313-213-3777
Mailing Address - Street 1:1931 GRAND WAY BLVD APT 220
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20721-2076
Mailing Address - Country:US
Mailing Address - Phone:313-213-3777
Mailing Address - Fax:
Practice Address - Street 1:1931 GRAND WAY BLVD APT 220
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20721-2076
Practice Address - Country:US
Practice Address - Phone:313-213-3777
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-15
Last Update Date:2025-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty