TRINA L. GREENWALD LLC (NPI# 1245574516) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245574516 |
| Entity Type | Organization |
| Organization Name | TRINA L. GREENWALD LLC |
| Other Organization Name | SERENITY CLINIC |
| Practice Address |
515 N Bradner Ave Marion IN 46952-2449 |
| Practice Telephone | 7656648000 |
| Practice Fax Number | 8777312066 |
| Mailing Telephone | 7656648000 |
| Enumeration Date | 2012-11-26 |
| Last Update Date | 2014-11-24 |
| Authorized Official Name | TRINA L GREENWALD (OWNER/PRACTITIONER) |
| Authorized Official Telephone | 7656648000 |
| Authorized Official Credential | FNP-C, PMHNP-BC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
71002182A | IN | Physician Assistants & Advanced Practice Nursing Providers |
| N | 364S00000X | Clinical Nurse Specialist | 28084011A | IN | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 200844580 | 05 |
| Other Name | Type Code |
|---|---|
| Serenity Clinic | Doing Business As Name - Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Indiana Business Entities | TRINA L GREENWALD LLC | 515 Bradner Ave, Marion, IN 46952 |
| Street Address |
515 N BRADNER AVE |
| City | MARION |
| State | IN |
| Zip Code | 46952-2449 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548298409 | Trina L Greenwald | Nurse Practitioner | 515 N Bradner Ave, Marion, IN 46952-2449 | 2006-06-29 |
| 1245840081 | Annalise Kathleen Michaud | Nurse Practitioner | 515 N Bradner Ave, Marion, IN 46952-2449 | 2020-08-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982245874 | John Robert Searfoss Sr. | Counselor | 314 S Norton Ave., Marion, IN 46952 | 2019-10-02 |
| 1063069755 | Andrea Marie Brown | Behavior Technician | 2315 W 2nd St, Marion, IN 46952 | 2019-08-19 |
| 1548767767 | Johnnie Micheal Hiles | Counselor | 315 South Norton Ave., Marion, IN 46952 | 2018-04-13 |
| 1669979936 | Sheila Ann Johnson | Counselor | 315 S. Norton Ave, Marion, IN 46952 | 2018-04-12 |
| 1679070957 | Marissa Lynn Castillo | Counselor | 315 S Norton Avenue, Marion, IN 46952 | 2018-04-12 |
| 1326545609 | Eumalla Lampkins | Case Manager/Care Coordinator | 315 South Norton Avenue, Marion, IN 46952 | 2018-04-12 |
| 1285011650 | Forefront Dermatology, S.c. | Dermatology | 330 N Wabash Ave Ste 360, Marion, IN 46952 | 2015-05-05 |
| 1649510959 | Cancer Services of Grant County Inc. | Prosthetic/Orthotic Supplier | 305 S. Norton Ave., Marion, IN 46952 | 2013-02-22 |
| 1326350844 | Beth Ellen Krouse | Speech-Language Pathologist | 1800 Wabash Ave, Suite 200, Marion, IN 46952 | 2010-07-13 |
| 1093032138 | Thomas Alfred Beck | General Practice | 919 Euclid Avenue, Marion, IN 46952 | 2010-04-29 |
| Find all providers in zip 46952 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235741745 | Lutheran Social Services of Illinois | Psychologist | 102 E Deyoung St, Marion, IL 62959-2724 | 2020-08-18 |
| 1457724650 | Michael J Belcher | Psychologist | 170 Fairfax Rd, Marion, OH 43302-6486 | 2015-11-10 |
| 1962654509 | Marlene Parker, Psy.d.,hspp,p.c. | Psychologist | 538 W 1st St, Marion, IN 46952-3767 | 2008-10-14 |
| 1689766784 | Christopher Michael Carusi | Psychologist | 434 Mitchell Valley Drive, Marion, VA 24354-6338 | 2006-09-28 |
| 1568478717 | John O Kling | Psychologist | 1700 38th Street, Psychiatry Service, Marion, IN 46953 | 2006-07-31 |
| 1376104943 | Step Up Care of Ohio LLC | Psychologist | 145 Baker St, Marion, OH 43302-4111 | 2019-06-25 |
| 1104392539 | Ryan Allen Hess | Psychologist | 1700 E 38th St, Marion, IN 46953-4568 | 2018-10-24 |
| 1134495583 | Jon Warshawsky | Psychologist | 103 E College St, Marion, IL 62959-2601 | 2012-03-30 |
| 1144506478 | Michelle L Melton | Psychologist | 340 Bagley Cir, Marion, VA 24354-3126 | 2011-11-01 |
| 1528380706 | Department of Veterans Affairs | Psychologist | 2401 W Main St, Marion, IL 62959-1188 | 2010-02-16 |
| Find all providers in MARION | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.