Provider Demographics
NPI:1669515078
Name:TROYER, CLARENCE RICHARD (LCSW)
Entity type:Individual
Prefix:
First Name:CLARENCE
Middle Name:RICHARD
Last Name:TROYER
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12900 PARK PLAZA DR
Mailing Address - Street 2:STE 150, MS 7110
Mailing Address - City:CERRITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90703-9329
Mailing Address - Country:US
Mailing Address - Phone:562-741-4470
Mailing Address - Fax:562-741-4479
Practice Address - Street 1:10030 ROBIOUS RD
Practice Address - Street 2:
Practice Address - City:NORTH CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23235-4818
Practice Address - Country:US
Practice Address - Phone:804-212-3450
Practice Address - Fax:804-267-3325
Is Sole Proprietor?:No
Enumeration Date:2007-02-15
Last Update Date:2013-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040062921041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA4945131OtherVIRGINIA PREMIER
VA0802670MOtherSENTARA
VA208377OtherANTHEM