Provider Demographics
NPI:1760569172
Name:ROTOLO, PATRICE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:PATRICE
Middle Name:
Last Name:ROTOLO
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 1:601 S STATE ROAD 7
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33317-4054
Mailing Address - Country:US
Mailing Address - Phone:954-321-2296
Mailing Address - Fax:954-321-5399
Practice Address - Street 1:601 S STATE ROAD 7
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33317-4054
Practice Address - Country:US
Practice Address - Phone:917-755-6478
Practice Address - Fax:718-993-0647
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2024-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0701631041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical