Healthcare Provider Details

I. General information

NPI: 1134886476
Provider Name (Legal Business Name): HEATHER MARIE TROTTA LCAT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/22/2021
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

205 HUDSON ST FL 9
NEW YORK NY
10013-1810
US

IV. Provider business mailing address

113 GLEN COVE AVE
GLEN COVE NY
11542-3438
US

V. Phone/Fax

Practice location:
  • Phone: 646-941-7645
  • Fax:
Mailing address:
  • Phone: 516-676-2388
  • Fax: 516-759-5259

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number13071
License Number StateNE
# 2
Primary TaxonomyY
Taxonomy Code221700000X
TaxonomyArt Therapist
License NumberP112993
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: