Healthcare Provider Details

I. General information

NPI: 1083550545
Provider Name (Legal Business Name): JOHN JOSEPH TROCHE LCSW, LCADC, CCS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/27/2026
Last Update Date: 04/27/2026
Certification Date: 04/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

486 ROUTE 10 W
RANDOLPH NJ
07869-2133
US

IV. Provider business mailing address

486 ROUTE 10 W
RANDOLPH NJ
07869-2133
US

V. Phone/Fax

Practice location:
  • Phone: 914-649-0707
  • Fax:
Mailing address:
  • Phone: 914-649-0707
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number44SC06347500
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: