Individual provider Active NPI

Kenneth Lafountain, MASTERS

  • Counselor
  • Cranston, RI
National Provider Identifier
1497957674
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Practice address
311 Doric Ave
Cranston, RI 02910-2903
Phone
(401) 784-3600
Fax
(401) 784-3636
NPI assigned
Jun 1, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X Primary

Addresses

Primary practice location

311 Doric Ave
Cranston, RI 02910-2903

Mailing address

311 Doric Ave
Cranston, RI 02910-2903
Phone (401) 784-3600

Other identifiers 1

IdentifierTypeStateIssuer
30343OtherRIBLUE CROSS CRISIS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI
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

Enrollment IDStateProvider typePAC IDDetails
I20240123000562 RI Practitioner - Mental Health Counselor 2264884519 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Lifespan Physician Group IncGroup PAC ID 2567455082, 1,151 clinicians

Practice addresses (Care Compare)

950 Warren Ave
Suite 104
East Providence, RI 02914-1432
Phone (401) 606-3711

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Lifespan Physician Group, Inc. CurrentSince Jan 1, 2024 Accepting new patients
Lifespan Physician Group, Inc. CurrentSince Jan 1, 2024 Accepting new patients

Locations

950 Warren Ave
Ste 104
East Providence, RI 02914
Phone (401) 606-0606

117 Ellenfield St
Ste 101
Providence, RI 02905
Phone (401) 444-4318

593 Eddy St
Providence, RI 02903

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1180656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1497957674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 DORIC AVE",
            "city": "CRANSTON",
            "state": "RI",
            "postal_code": "029102903",
            "telephone_number": "401-784-3600",
            "fax_number": "401-784-3636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 DORIC AVE",
            "city": "CRANSTON",
            "state": "RI",
            "postal_code": "029102903",
            "telephone_number": "401-784-3600",
            "fax_number": "401-784-3636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAFOUNTAIN",
        "first_name": "KENNETH",
        "credential": "MASTERS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS CRISIS",
            "identifier": "30343",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cranston, RI

Sources for this page

Verify at the official NPI Registry.