Provider Demographics
NPI:1235684804
Name:TROOP, ECHO (LCSW)
Entity Type:Individual
Prefix:
First Name:ECHO
Middle Name:
Last Name:TROOP
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:650 EDISON WAY
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89502-4100
Mailing Address - Country:US
Mailing Address - Phone:775-284-4717
Mailing Address - Fax:775-284-4595
Practice Address - Street 1:650 EDISON WAY
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502
Practice Address - Country:US
Practice Address - Phone:775-284-4717
Practice Address - Fax:775-284-4595
Is Sole Proprietor?:No
Enumeration Date:2016-08-24
Last Update Date:2018-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV8011-C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1003069485Medicaid