Brandy Thelma Fountain, LPCC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

2823 Lexington Ave N
Apt 103
Roseville, MN 55113-2086

Phone

(612) 275-3985

NPI assigned

Sep 12, 2016

Last updated

Jul 22, 2024By 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 MN

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

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• People Incorporated

  • Community/Behavioral Health Agency
  • Minneapolis, MN
  • NPI 1215104831
  Medicare reassignment NPD

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

{
    "created_epoch": "1473638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721606400000",
    "number": "1457809139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2823 LEXINGTON AVE N",
            "address_2": "APT 103",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "551132086",
            "telephone_number": "612-275-3985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2823 LEXINGTON AVE N",
            "address_2": "APT 103",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "551132086",
            "telephone_number": "612-275-3985"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5555 Boone Ave N",
            "address_purpose": "LOCATION",
            "city": "New Hope",
            "state": "MN",
            "postal_code": "554283636",
            "country_code": "US",
            "telephone_number": "651-774-0011",
            "fax_number": "651-774-0606",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FOUNTAIN",
        "first_name": "BRANDY",
        "middle_name": "THELMA",
        "credential": "LPCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-09-12",
        "last_updated": "2024-07-22",
        "certification_date": "2024-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alison J Forney, MD
• Jamie L. Fort, M.D.
• Christopher Gary Foss, MD
• Christine Fossum, CNP
• Foundation of Hope Inc
• Kayla Fraser
• Dominic F Frecentese, MD
• Robert Freed
• Bryan Freisinger
• Thomas Frerichs, M.D.

• Mental Health Counselor in Roseville, MN
• Providers in Roseville, MN by specialty
• Mental Health Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.