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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