Healthcare Provider Details

I. General information

NPI: 1629917547
Provider Name (Legal Business Name): ADDISON ELIZABETH TROUTMAN-PROANO LCMHCA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/26/2026
Last Update Date: 03/26/2026
Certification Date: 03/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7406 CHAPEL HILL RD STE J
RALEIGH NC
27607-5039
US

IV. Provider business mailing address

7406 CHAPEL HILL RD STE J
RALEIGH NC
27607-5039
US

V. Phone/Fax

Practice location:
  • Phone: 919-283-8994
  • Fax: 919-573-0438
Mailing address:
  • Phone:
  • Fax: 919-573-0438

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberA21923
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: