Provider Demographics
NPI:1689053357
Name:TROCHE, MARISOL (MSED, LPC)
Entity Type:Individual
Prefix:
First Name:MARISOL
Middle Name:
Last Name:TROCHE
Suffix:
Gender:F
Credentials:MSED, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 DANBURY RD STE D&E
Mailing Address - Street 2:APT/SUITE
Mailing Address - City:RIDGEFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06877-4067
Mailing Address - Country:US
Mailing Address - Phone:917-686-9921
Mailing Address - Fax:
Practice Address - Street 1:15 DANBURY RD STE D&E
Practice Address - Street 2:APT/SUITE
Practice Address - City:RIDGEFIELD
Practice Address - State:CT
Practice Address - Zip Code:06877-4067
Practice Address - Country:US
Practice Address - Phone:917-686-9921
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-27
Last Update Date:2015-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT002586101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional