Provider Demographics
NPI:1538495387
Name:LOVE, TROY L (LCSW)
Entity Type:Individual
Prefix:MR
First Name:TROY
Middle Name:L
Last Name:LOVE
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 1:1427 S 35TH DR
Mailing Address - Street 2:
Mailing Address - City:YUMA
Mailing Address - State:AZ
Mailing Address - Zip Code:85364-4194
Mailing Address - Country:US
Mailing Address - Phone:928-276-9535
Mailing Address - Fax:
Practice Address - Street 1:2201 S AVENUE A
Practice Address - Street 2:102
Practice Address - City:YUMA
Practice Address - State:AZ
Practice Address - Zip Code:85364-8459
Practice Address - Country:US
Practice Address - Phone:928-287-3621
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-10-29
Last Update Date:2013-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLCSW-104491041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical