Provider Demographics
NPI:1659692077
Name:TROICKI, STACEY MICHELLE (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:STACEY
Middle Name:MICHELLE
Last Name:TROICKI
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 1:32 FORD AVENUE
Mailing Address - Street 2:JEWISH FAMILY AND VOCATIONAL SERVICE
Mailing Address - City:MILLTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:08850
Mailing Address - Country:US
Mailing Address - Phone:732-777-1940
Mailing Address - Fax:732-777-1889
Practice Address - Street 1:32 FORD AVENUE
Practice Address - Street 2:
Practice Address - City:MILLTOWN
Practice Address - State:NJ
Practice Address - Zip Code:08850
Practice Address - Country:US
Practice Address - Phone:732-777-1940
Practice Address - Fax:732-777-1889
Is Sole Proprietor?:No
Enumeration Date:2010-06-21
Last Update Date:2010-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC054285001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical