Charisse Cannady Fountain, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

SW9262 Issued in FL

Practice address

1503 Cayman Way
Unit E-1
Coconut Creek, FL 33066-1435

Phone

(352) 870-4675

NPI assigned

Mar 26, 2021

Last updated

Mar 26, 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

Enrolled in FL

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

Clinical Social Worker

Education

Other, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Mental Health Specialty Group PAGroup PAC ID 8921466228, 726 clinicians

A and B Counseling Services LLCGroup PAC ID 6103152269, 73 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• A & B Counseling Services LLC

  • Adult Mental Health Clinic/Center
  • Fort Lauderdale, FL
  • NPI 1508327628
  Medicare reassignment Care Compare group NPD
• Mental Health Specialty Group PA

  dba Rula Health

  • Mental Health Counselor
  • Durham, NC
  • NPI 1801472634

  FL

  Medicare reassignment Care Compare group NPD
• Mindy Staum, LCSW, P.a

  • Clinical Social Worker
  • Coral Springs, FL
  • NPI 1083922561
  Medicare reassignment NPD
• A & B Counseling LLC

  • In Home Supportive Care Agency
  • Fort Lauderdale, FL
  • NPI 1316400203
  NPD (past)

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

{
    "created_epoch": "1616716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616716800000",
    "number": "1346827177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1503 CAYMAN WAY",
            "address_2": "UNIT E-1",
            "city": "COCONUT CREEK",
            "state": "FL",
            "postal_code": "330661435",
            "telephone_number": "352-870-4675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1503 CAYMAN WAY",
            "address_2": "UNIT E-1",
            "city": "COCONUT CREEK",
            "state": "FL",
            "postal_code": "330661435",
            "telephone_number": "352-870-4675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOUNTAIN",
        "first_name": "CHARISSE",
        "middle_name": "CANNADY",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-03-26",
        "last_updated": "2021-03-26",
        "certification_date": "2021-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW9262",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Adrian Earl Dwight Forrest, PHARM.D.
• Mark M Fortney, PA
• Norma Forwand
• Kristyn Foster
• Rachel Noel Foster, M.S. CCC-SLP
• Addis Isabel Fraga Barrios, RBT
• Kaya S Frallicciardi
• Sherby Francois
• Frank Lavernia MD PA
• Heather Katherine Frank, OD

• Clinical Social Worker in Coconut Creek, FL
• Providers in Coconut Creek, FL by specialty
• Clinical Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2021; 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.