Provider Demographics
NPI:1679953129
Name:TROTMAN PSYCHOTHERAPY AND CONSULTING, LLC
Entity Type:Organization
Organization Name:TROTMAN PSYCHOTHERAPY AND CONSULTING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CAROL-ANN
Authorized Official - Middle Name:
Authorized Official - Last Name:TROTMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-245-0470
Mailing Address - Street 1:PO BOX 470
Mailing Address - Street 2:
Mailing Address - City:SAVAGE
Mailing Address - State:MD
Mailing Address - Zip Code:20763-0470
Mailing Address - Country:US
Mailing Address - Phone:240-245-0470
Mailing Address - Fax:
Practice Address - Street 1:9470 ANNAPOLIS RD
Practice Address - Street 2:SUITE 117
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706-3025
Practice Address - Country:US
Practice Address - Phone:240-245-0470
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-30
Last Update Date:2015-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC3553101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD446623300Medicaid