Provider Demographics
NPI:1417210105
Name:TROZZI, JUSTIN C (LCSW)
Entity Type:Individual
Prefix:
First Name:JUSTIN
Middle Name:C
Last Name:TROZZI
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37 MILL ST # 7
Mailing Address - Street 2:
Mailing Address - City:BRUNSWICK
Mailing Address - State:ME
Mailing Address - Zip Code:04011-1914
Mailing Address - Country:US
Mailing Address - Phone:207-319-6664
Mailing Address - Fax:
Practice Address - Street 1:37 MILL ST # 7
Practice Address - Street 2:
Practice Address - City:BRUNSWICK
Practice Address - State:ME
Practice Address - Zip Code:04011-1914
Practice Address - Country:US
Practice Address - Phone:207-319-6664
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-19
Last Update Date:2019-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC148861041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical