Provider Demographics
NPI:1437169182
Name:TROST, LENE
Entity Type:Individual
Prefix:MS
First Name:LENE
Middle Name:
Last Name:TROST
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:LENE
Other - Middle Name:G
Other - Last Name:HANSEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1212 S 70TH ST
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53214-3105
Mailing Address - Country:US
Mailing Address - Phone:414-453-1400
Mailing Address - Fax:414-453-2538
Practice Address - Street 1:1212 S 70TH ST
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53214-3105
Practice Address - Country:US
Practice Address - Phone:414-453-1400
Practice Address - Fax:414-453-2538
Is Sole Proprietor?:No
Enumeration Date:2006-08-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4006-1231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical