Active NPI
Michael D Fountain, MA, NCC, LAPC
- Professional Counselor
- Atlanta, GA
National Provider Identifier
1346532843
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 0002892
- Practice address
- 1870 Roble Drive
Atlanta, GA 30349-9117 - Phone
- (678) 235-4939
- Fax
- (770) 994-5444
- NPI assigned
- May 3, 2011
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 0002892 | GA | Primary |
Addresses
Primary practice location
1870 Roble Drive
Atlanta, GA 30349-9117
Mailing address
PO Box 491117
Atlanta, GA 30349-9117
Phone (678) 235-4939
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0002892 | GA | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1304380800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1304380800000",
"number": "1346532843",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 491117",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303499117",
"telephone_number": "678-235-4939",
"fax_number": "770-994-5444"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1870 ROBLE DRIVE",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303499117",
"telephone_number": "678-235-4939",
"fax_number": "770-994-5444"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FOUNTAIN",
"first_name": "MICHAEL",
"middle_name": "D",
"credential": "MA, NCC, LAPC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-05-03",
"last_updated": "2011-05-03",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "GA",
"license": "0002892",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Atlanta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.