Healthcare Provider Details

I. General information

NPI: 1487667572
Provider Name (Legal Business Name): PATRICIA D. STROTT LCSW-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/13/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11042 NICHOLAS LN SUITE 103B
OCEAN PINES MD
21811-3299
US

IV. Provider business mailing address

11042 NICHOLAS LN SUITE 103B
OCEAN PINES MD
21811-3299
US

V. Phone/Fax

Practice location:
  • Phone: 410-208-4784
  • Fax: 410-208-4786
Mailing address:
  • Phone: 410-208-4784
  • Fax: 410-208-4786

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number05719
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: