Provider Demographics
NPI:1245304161
Name:TROSKO, WILLIAM MICHAEL (MA CFAP CAC CPC)
Entity type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:MICHAEL
Last Name:TROSKO
Suffix:
Gender:M
Credentials:MA CFAP CAC CPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1434 FLUSHING ROAD
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:MI
Mailing Address - Zip Code:48433
Mailing Address - Country:US
Mailing Address - Phone:810-908-3397
Mailing Address - Fax:810-605-2177
Practice Address - Street 1:1434 FLUSHING ROAD
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:MI
Practice Address - Zip Code:48433
Practice Address - Country:US
Practice Address - Phone:810-908-3397
Practice Address - Fax:810-605-2177
Is Sole Proprietor?:No
Enumeration Date:2006-11-20
Last Update Date:2015-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401006597101Y00000X
MI6301005357103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
049515OtherVALUE OPTIONS
79355OtherCIGNA