Provider Demographics
NPI:1841033164
Name:FLICK, TREVOR JAMES (MA)
Entity type:Individual
Prefix:MR
First Name:TREVOR
Middle Name:JAMES
Last Name:FLICK
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6375 W 143RD ST
Mailing Address - Street 2:
Mailing Address - City:SAVAGE
Mailing Address - State:MN
Mailing Address - Zip Code:55378-2888
Mailing Address - Country:US
Mailing Address - Phone:952-592-2200
Mailing Address - Fax:
Practice Address - Street 1:6375 W 143RD ST
Practice Address - Street 2:
Practice Address - City:SAVAGE
Practice Address - State:MN
Practice Address - Zip Code:55378-2888
Practice Address - Country:US
Practice Address - Phone:952-592-2200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-14
Last Update Date:2025-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program