Provider Demographics
NPI:1356856595
Name:TROTTER, PAUL (MBA, MS, LPC-A)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:
Last Name:TROTTER
Suffix:
Gender:M
Credentials:MBA, MS, LPC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 STONECREEK DR
Mailing Address - Street 2:
Mailing Address - City:APEX
Mailing Address - State:NC
Mailing Address - Zip Code:27539-9733
Mailing Address - Country:US
Mailing Address - Phone:919-904-8170
Mailing Address - Fax:
Practice Address - Street 1:500 STONECREEK DR
Practice Address - Street 2:
Practice Address - City:APEX
Practice Address - State:NC
Practice Address - Zip Code:27539-9733
Practice Address - Country:US
Practice Address - Phone:919-904-8170
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-11
Last Update Date:2017-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA13252101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health