Basic Information
| Provider Information | |||||||||
| NPI: | 1871735514 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | WARNER | ||||||||
| FirstName: | TRINYA | ||||||||
| MiddleName: | DEE | ||||||||
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| Credential: | M.S. ED., CAS | ||||||||
| OtherOrganizationName: | |||||||||
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| OtherLastName: | CICHY | ||||||||
| OtherFirstName: | TRINYA | ||||||||
| OtherMiddleName: | DEE | ||||||||
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| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 230 WASHINGTON AVE EXTENTION | ||||||||
| Address2: | |||||||||
| City: | ALBANY | ||||||||
| State: | NY | ||||||||
| PostalCode: | 12203 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5184563268 | ||||||||
| FaxNumber: | 5184641469 | ||||||||
| Practice Location | |||||||||
| Address1: | 314 S MANNING BLVD | ||||||||
| Address2: | |||||||||
| City: | ALBANY | ||||||||
| State: | NY | ||||||||
| PostalCode: | 122081708 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5184375717 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/26/2009 | ||||||||
| LastUpdateDate: | 05/10/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103TS0200X | 304691371189092 | NY | Y | Behavioral Health & Social Service Providers | Psychologist | School | 103TS0200X | N | Behavioral Health & Social Service Providers | Psychologist | School |
No ID Information.