Traci Rosvall, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

37317 Issued in TX

Practice address

17000 Preston Rd Ste 350
Dallas, TX 75248-1240

Phone

(972) 250-1705

Fax

(972) 250-1710

NPI assigned

Jan 31, 2018

Last updated

Jun 15, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in UT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: trosvall575738@direct.med.utah.edu

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• University of Utah

  dba University Health Care Hospitals and Clinics

  • General Acute Care Hospital
  • Salt Lake City, UT
  • NPI 1588656870
  Medicare reassignment NPD
• University of Utah Behavioral Health Services

  dba College of Nursing, Mental Health Services

  • Psychiatry Physician
  • Salt Lake City, UT
  • NPI 1740688613
  Medicare reassignment NPD
• University of Utah Pediatric Behavioral Health Services

  dba Pediatric Behavioral Health

  • Developmental - Behavioral Pediatrics Physician
  • Salt Lake City, UT
  • NPI 1649631599
  Medicare reassignment NPD
• University of Utah

  dba University Health Care

  • General Acute Care Hospital
  • Salt Lake City, UT
  • NPI 1699889576
  NPD
• University of Utah Behavioral Health Services

  dba Adult Sports Psychiatry

  • Sports Medicine (Psychiatry & Neurology) Physician
  • Salt Lake City, UT
  • NPI 1740158955
  NPD
• University of Utah Behavioral Health Services

  dba Dept. of Psychiatry, Girls Transition Center - South Main Clinic

  • Developmental - Behavioral Pediatrics Physician
  • Salt Lake City, UT
  • NPI 1952751513
  NPD
• University of Utah Pediatric Behavioral Health Services

  dba Pediatric Sports Psychiatry

  • Sports Medicine (Psychiatry & Neurology) Physician
  • Salt Lake City, UT
  • NPI 1467320671
  NPD
• University of Utah Pediatric Behavioral Health Services

  dba HMHI Downtown Outpatient Clinic - Child

  • Adolescent and Children Mental Health Clinic/Center
  • Salt Lake City, UT
  • NPI 1477915379
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1517356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655251200000",
    "number": "1518465913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17000 PRESTON RD STE 350",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752481240",
            "telephone_number": "972-250-1705",
            "fax_number": "972-250-1710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17000 PRESTON RD STE 350",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752481240",
            "telephone_number": "972-250-1705",
            "fax_number": "972-250-1710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSVALL",
        "first_name": "TRACI",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-31",
        "last_updated": "2022-06-15",
        "certification_date": "2022-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TX",
            "license": "37317",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "TROSVALL575738@DIRECT.MED.UTAH.EDU",
            "affiliation": "Y",
            "affiliationName": "University of Utah",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "50 N Medical Dr",
            "city": "Salt Lake City",
            "state": "UT",
            "country_code": "US",
            "postal_code": "841320001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Claudia Rosso, MD
• Daria Rossum
• Shireen Sarah Rostami, PA-C
• Mason Andrew Rostollan
• Ramona Roston, LICENSED SOCIAL WORK
• Casey Roth, M.D.
• Don Allen Roth, P.A.-C
• Jonathan Stephen Roth
• Lauren Roth, LPC
• Lori R. Roth, PA-C

• Clinical Psychologist in Dallas, TX
• Providers in Dallas, TX by specialty
• Clinical Psychologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.