Provider Demographics
NPI:1679614788
Name:TROISI, DONNA M (BCD, LCSW-C)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:M
Last Name:TROISI
Suffix:
Gender:F
Credentials:BCD, 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:P.O. BOX 56
Mailing Address - Street 2:
Mailing Address - City:BOYDS
Mailing Address - State:MD
Mailing Address - Zip Code:20841-0056
Mailing Address - Country:US
Mailing Address - Phone:240-281-8319
Mailing Address - Fax:
Practice Address - Street 1:12105 DARNESTOWN RD
Practice Address - Street 2:STE 28
Practice Address - City:NORTH POTOMAC
Practice Address - State:MD
Practice Address - Zip Code:20878-2217
Practice Address - Country:US
Practice Address - Phone:240-281-8319
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-09
Last Update Date:2018-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD034481041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD709200800Medicaid