Elisabeth Troffo Fountain, PSYD, BCBA-D
Individual provider Active NPI Psychologist · Richardson, TX
NPI 1043613698 · NPPES record last updated Apr 30, 2019
Key facts
- NPI
- 1043613698
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychologist 103T00000X
- License
- 37168 (TX)
- Practice address
- 1001 E Lookout Dr
Richardson, TX 75082-4144 - Phone
- (972) 766-4470
- NPI assigned
- Sep 26, 2014
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 37168 | TX | MD | Psychologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | 1-12-12684 | TX | |
| Psychologist | 103T00000X | 37168 | TX | Yes |
Addresses
Primary practice location
1001 E Lookout Dr
Richardson, TX 75082-4144
Mailing address
225 Hadfield Rd
Downingtown, PA 19335-4904
Other practice location 1
9696 Skillman St # 220
Dallas, TX 75243-8264
Phone (972) 591-3241
Other providers in Richardson, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 30, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.