Provider Demographics
NPI:1710688262
Name:TROXEL, ANDREW JOHN
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:JOHN
Last Name:TROXEL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:223 S WEST ST
Mailing Address - Street 2:
Mailing Address - City:CROWN POINT
Mailing Address - State:IN
Mailing Address - Zip Code:46307-3907
Mailing Address - Country:US
Mailing Address - Phone:219-902-9282
Mailing Address - Fax:
Practice Address - Street 1:223 S WEST ST
Practice Address - Street 2:
Practice Address - City:CROWN POINT
Practice Address - State:IN
Practice Address - Zip Code:46307-3907
Practice Address - Country:US
Practice Address - Phone:219-902-9282
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-13
Last Update Date:2023-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN33009726A104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker