Provider Demographics
NPI:1609943323
Name:TROUNSTINE, PEGGY A (LCSW)
Entity Type:Individual
Prefix:MS
First Name:PEGGY
Middle Name:A
Last Name:TROUNSTINE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 KAATSKILL WAY
Mailing Address - Street 2:
Mailing Address - City:BALLSTON SPA
Mailing Address - State:NY
Mailing Address - Zip Code:12020-3002
Mailing Address - Country:US
Mailing Address - Phone:518-583-6474
Mailing Address - Fax:518-587-9356
Practice Address - Street 1:433 BROADWAY
Practice Address - Street 2:SUITE 203
Practice Address - City:SARATOGA SPRINGS
Practice Address - State:NY
Practice Address - Zip Code:12866-2367
Practice Address - Country:US
Practice Address - Phone:518-583-0381
Practice Address - Fax:518-587-9356
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR033694-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY55664BMedicare ID - Type UnspecifiedCLINICAL SOCIAL WORKER