Provider Demographics
NPI:1942552708
Name:TROMICZAK, CAITLIN (LICSW-C)
Entity Type:Individual
Prefix:
First Name:CAITLIN
Middle Name:
Last Name:TROMICZAK
Suffix:
Gender:F
Credentials:LICSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6645 GEORGIA AVE NW
Mailing Address - Street 2:#102
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20012-2564
Mailing Address - Country:US
Mailing Address - Phone:202-834-0291
Mailing Address - Fax:
Practice Address - Street 1:1211 U ST NW
Practice Address - Street 2:3RD FLOOR
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20009-4465
Practice Address - Country:US
Practice Address - Phone:202-667-4151
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-03
Last Update Date:2012-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC500791881041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical