Provider Demographics
NPI:1144250374
Name:TROTTA, MARCI (LSCSW)
Entity type:Individual
Prefix:MS
First Name:MARCI
Middle Name:
Last Name:TROTTA
Suffix:
Gender:F
Credentials:LSCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4111 CONCORD WAY
Mailing Address - Street 2:
Mailing Address - City:PLANT CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33566-9515
Mailing Address - Country:US
Mailing Address - Phone:913-362-8899
Mailing Address - Fax:913-362-8899
Practice Address - Street 1:915 S PARSONS AVE
Practice Address - Street 2:SUITE C
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33511-6000
Practice Address - Country:US
Practice Address - Phone:913-362-8899
Practice Address - Fax:913-362-8899
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-04
Last Update Date:2017-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS37201041C0700X
FLSW 143651041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
KSKA4004Medicare PIN