Provider Demographics
NPI:1003035056
Name:TROILO, JENNIFER NOYES (LICSW)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:NOYES
Last Name:TROILO
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:NOYES
Other - Last Name:GARNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LICSW
Mailing Address - Street 1:19 CEDAR ST
Mailing Address - Street 2:
Mailing Address - City:TAUNTON
Mailing Address - State:MA
Mailing Address - Zip Code:02780-3301
Mailing Address - Country:US
Mailing Address - Phone:508-823-6124
Mailing Address - Fax:
Practice Address - Street 1:19 CEDAR ST
Practice Address - Street 2:
Practice Address - City:TAUNTON
Practice Address - State:MA
Practice Address - Zip Code:02780-3301
Practice Address - Country:US
Practice Address - Phone:508-823-6124
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-25
Last Update Date:2014-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1169821041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical