Provider Demographics
NPI:1326733387
Name:TROTTA, CASEY MICHEAL (LMSW)
Entity Type:Individual
Prefix:
First Name:CASEY
Middle Name:MICHEAL
Last Name:TROTTA
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:479 PROSPECT PL APT 3R
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11238-4178
Mailing Address - Country:US
Mailing Address - Phone:845-283-0475
Mailing Address - Fax:
Practice Address - Street 1:479 PROSPECT PL APT 3R
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11238-4178
Practice Address - Country:US
Practice Address - Phone:845-283-0475
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-06
Last Update Date:2023-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1194061041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical