Perry Townsend Fountain, MSW, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

CO14567 Issued in NC

Practice address

815 Oberlin Rd Ste 200
Raleigh, NC 27605-1351

Phone

(919) 322-4722

NPI assigned

Jul 23, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

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, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Avance Care PAGroup PAC ID 3577634476, 244 clinicians

Practice addresses (Care Compare)

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 and National Provider Directory roles.

• Avance Care, PA

  • Clinic/Center
  • Fuquay Varina, NC
  • NPI 1487845020
  Medicare reassignment Care Compare group NPD
• Carolina Outreach, LLC

  • Clinical Social Worker
  • Durham, NC
  • NPI 1083723266
  Medicare reassignment NPD
• Carolina Outreach, LLC

  • Community/Behavioral Health Agency
  • Durham, NC
  • NPI 1508171216

  Clinical

  NPD
• Carolina Outreach, LLC

  • Clinical Social Worker
  • Asheville, NC
  • NPI 1518110139
  NPD

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

{
    "created_epoch": "1563840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654732800000",
    "number": "1457904054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10900 WORLD TRADE BLVD",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276174202",
            "telephone_number": "919-237-1337",
            "fax_number": "919-237-1625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "815 OBERLIN RD STE 200",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276051351",
            "telephone_number": "919-322-4722"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3012 Falstaff Rd",
            "address_purpose": "LOCATION",
            "city": "Raleigh",
            "state": "NC",
            "postal_code": "276101813",
            "country_code": "US",
            "telephone_number": "919-615-1027",
            "fax_number": "919-615-1501",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FOUNTAIN",
        "first_name": "PERRY",
        "middle_name": "TOWNSEND",
        "name_prefix": "Miss",
        "credential": "MSW, LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-23",
        "last_updated": "2022-06-09",
        "certification_date": "2022-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "P013521",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "CO14567",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Foundation Restoration Inc.
• Foundations Counseling Services, PLLC
• Foundations Nutrition LLC
• Foundations Pediatric Therapy PLLC
• Foundations United, PA
• Shepherd Macdougald Fountain, LCSW LCAS
• Danielle Fouratt, BOA
• Jacquetta Melony Foushee, M.D.
• Jocelyn Germis Foust, P-LCSW
• Aleeza Fowler

• Clinical Social Worker in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2022; 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.