# TRINITY COMMUNITY MEDICAL CLINIC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1720755895
- **Authorized official:** MS. MARY E MARTINEZ (CONSULTANT)
- **Authorized official phone:** (504) 417-3728

## Contact information

- **Practice address:** 8451 HIGHWAY 23 STE 1, BELLE CHASSE, LA 70037-2594
- **Practice address phone:** (504) 417-3728
- **Mailing address:** 8451 HIGHWAY 23 STE 1, BELLE CHASSE, LA 70037-2594
- **Mailing address phone:** (504) 417-3728

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YM0800X | Mental Health Counselor | — | NULL | — |
| 101YM0800X | Mental Health Counselor | — | — | — |
| 104100000X | Social Worker | — | NULL | — |
| 104100000X | Social Worker | — | — | — |
| 163WC1500X | Community Health Registered Nurse | — | NULL | — |
| 163WC1500X | Community Health Registered Nurse | — | — | — |
| 163WG0000X | General Practice Registered Nurse | — | NULL | — |
| 163WG0000X | General Practice Registered Nurse | — | — | — |
| 207Q00000X | Family Medicine Physician | — | NULL | — |
| 207Q00000X | Family Medicine Physician | — | — | — |
| 207QA0000X | Adolescent Medicine (Family Medicine) Physician | — | NULL | — |
| 207QA0000X | Adolescent Medicine (Family Medicine) Physician | — | — | — |
| 207QA0505X | Adult Medicine Physician | — | NULL | Yes |
| 207QA0505X | Adult Medicine Physician | — | — | Yes |
| 363LP2300X | Primary Care Nurse Practitioner | — | NULL | — |
| 363LP2300X | Primary Care Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 08/26/2021
- **Last updated:** 01/11/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 01 | COMMERCIAL INSURANCE | LA |
| 05 | — | 05 | — | LA |