Kathleen Fountain, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

0904012417 Issued in VA

Practice address

4813B Eisenhower Ave
Alexandria, VA 22304-4832

Phone

(571) 402-2541

NPI assigned

Mar 23, 2021

Last updated

Mar 23, 2021By the provider in NPPES

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• Kelda Counseling LLC

  • Clinical Social Worker
  • Yuma, AZ
  • NPI 1083475016
  NPD

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

{
    "created_epoch": "1616457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616457600000",
    "number": "1295311918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 S BRAHMA BLVD APT 30A",
            "city": "KINGSVILLE",
            "state": "TX",
            "postal_code": "783637341",
            "telephone_number": "703-201-3191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4813B EISENHOWER AVE",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223044832",
            "telephone_number": "571-402-2541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOUNTAIN",
        "first_name": "KATHLEEN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-03-23",
        "last_updated": "2021-03-23",
        "certification_date": "2021-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904012417",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lauren Foster, OTR/L OTD
• Chancellor Eugene Foulks, DC
• Foundations Physical Therapy, LLC
• Fountain Medical Transport LLC
• Fountain Medicals LLC
• Fountains Washington House SL, LLC (The Washington House)
• Mariya Fox-Rabinovich, MA, RD, LDN, CDCES
• Christopher Hughes Fox, DMD, DMSC
• Heather Fox, LMT
• Joan Fox, LCSW

• Clinical Social Worker in Alexandria, VA
• Providers in Alexandria, VA by specialty
• Clinical Social Worker in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.