Provider Demographics
NPI:1083652739
Name:TRENT, MICHON (LICSW)
Entity type:Individual
Prefix:
First Name:MICHON
Middle Name:
Last Name:TRENT
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3100 COTTAGE HILL RD STE 202
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36606-2929
Mailing Address - Country:US
Mailing Address - Phone:251-454-1745
Mailing Address - Fax:
Practice Address - Street 1:3100 COTTAGE HILL RD STE 202
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36606-2929
Practice Address - Country:US
Practice Address - Phone:251-454-1745
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-03
Last Update Date:2025-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS14401041C0700X
AL2054C-S1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS070554OtherBLUE CROSS BLUE SHIELD
KS8369OtherPREFERRED HEALTH SYSTEMS
KSQ28027Medicare UPIN
KS070554Medicare ID - Type Unspecified