Provider Demographics
NPI:1063542413
Name:LOTOCZKY, SHARON A (LMSW)
Entity type:Individual
Prefix:MRS
First Name:SHARON
Middle Name:A
Last Name:LOTOCZKY
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2888 E LONG LAKE RD STE 145
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48085-7010
Mailing Address - Country:US
Mailing Address - Phone:248-528-1756
Mailing Address - Fax:248-680-0431
Practice Address - Street 1:2888 E LONG LAKE RD STE 145
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48085-7010
Practice Address - Country:US
Practice Address - Phone:248-528-1756
Practice Address - Fax:248-680-0431
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010659301041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical