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Organization
ELITE PSYCHOTHERAPY AND BEHAVIORAL HEALTH SERVICES, LLC
Active
Organization
ELITE PSYCHOTHERAPY AND BEHAVIORAL HEALTH SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TINA M. FOUNTAIN LCSW (OWNER)
(804) 677-0379
Entity
Organization
Contact information
Practice address
612 HULL ST STE 101A, RICHMOND, VA 23224-4180
(804) 351-5971
(804) 351-5972
Mailing address
3209 OAKINGTON DR, RICHMOND, VA 23231-7267
(804) 677-0379
(804) 351-5972
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0904005723
VA
Other
Enumeration date
09/25/2016
Last updated
02/27/2026
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