Provider Demographics
NPI:1487667572
Name:STROTT, PATRICIA D (LCSW-C)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:D
Last Name:STROTT
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11042 NICHOLAS LN
Mailing Address - Street 2:SUITE 103B
Mailing Address - City:OCEAN PINES
Mailing Address - State:MD
Mailing Address - Zip Code:21811-3299
Mailing Address - Country:US
Mailing Address - Phone:410-208-4784
Mailing Address - Fax:410-208-4786
Practice Address - Street 1:11042 NICHOLAS LN
Practice Address - Street 2:SUITE 103B
Practice Address - City:OCEAN PINES
Practice Address - State:MD
Practice Address - Zip Code:21811-3299
Practice Address - Country:US
Practice Address - Phone:410-208-4784
Practice Address - Fax:410-208-4786
Is Sole Proprietor?:No
Enumeration Date:2006-08-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD057191041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDG8000003OtherBCBS NATIONAL
MD42465004OtherBCBS OF MD
MDPVPB94645OtherAPS
MD2125727OtherMAMSI
MD7444169OtherAETNA
MDPVPB94645OtherAPS