Tracy Dian Fountain, BHRS

Primary specialty

CounselorTaxonomy code 101Y00000X

Practice address

27753 S Welling Rd
Welling, OK 74471-2202

Phone

(918) 457-4999

Fax

(918) 457-4104

NPI assigned

Jan 6, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OK

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

Specialty

Mental Health Counselor

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Improving Lives Counseling Services IncGroup PAC ID 3870818230, 32 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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

• Improving Lives Counseling Services, Inc.

  • Community/Behavioral Health Agency
  • Tulsa, OK
  • NPI 1487967444

  OK

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1325808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1325808000000",
    "number": "1194095273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27753 S WELLING RD",
            "city": "WELLING",
            "state": "OK",
            "postal_code": "744712202",
            "telephone_number": "918-457-4999",
            "fax_number": "918-457-4104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27753 S WELLING RD",
            "city": "WELLING",
            "state": "OK",
            "postal_code": "744712202",
            "telephone_number": "918-457-4999",
            "fax_number": "918-457-4104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOUNTAIN",
        "first_name": "TRACY",
        "middle_name": "DIAN",
        "credential": "BHRS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-01-06",
        "last_updated": "2012-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jody Lynn Dallis, BSW
• Sue Ella Dalrymple
• Patricia Ann Daniel, OTRL
• Janus Farar, BHRS
• Karen Ford, BSED
• Sandra Girdner, BS
• Becky Gonelli
• Deanna Earlene Harris, BSW
• Brandon Kirk Hembree
• Melissa Kelley

• All providers in Welling, OK
• Counselor in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2012; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.