Princewill Fonta, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

AP70059722 Issued in WA

Practice address

711 State Ave NE
Olympia, WA 98506-3984

Phone

(360) 943-0780

NPI assigned

Jul 19, 2022

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in MA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Group practices

Northeast Behavioral Health LLCGroup PAC ID 7517287444, 18 clinicians

Cornerstone Wellness Center PCGroup PAC ID 2163873704, 4 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Southcoast Hospitals Group Hospital, Fall River, MA, CCN 220074

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.

• Cornerstone Wellness Center PC

  • Mental Health Counselor
  • Dartmouth, MA
  • NPI 1285418681
  Medicare reassignment Care Compare group NPD
• Movement Wellness

  • Psychiatric/Mental Health Nurse Practitioner
  • New Bedford, MA
  • NPI 1265267231
  Medicare reassignment NPD Authorized official
• Northeast Behavioral Health, LLC

  • Psychiatric Hospital
  • Dartmouth, MA
  • NPI 1275920001
  Medicare reassignment Care Compare group NPD
• Child & Family Services, Inc.

  • Mental Health Counselor
  • New Bedford, MA
  • NPI 1205813540
  Medicare reassignment NPD
• Olivier Group, P.C.

  • Psychiatric/Mental Health Nurse Practitioner
  • N Dartmouth, MA
  • NPI 1316198690
  Medicare reassignment NPD
• South Shore Mental Health Center, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Quincy, MA
  • NPI 1770528317
  Medicare reassignment NPD
• Living Hope Healthcare LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • New Bedford, MA
  • NPI 1295413201
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Southcoast Hospitals Group, Inc

  • General Acute Care Hospital
  • Wareham, MA
  • NPI 1922024835
  Care Compare affiliation

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

{
    "created_epoch": "1658188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779148800000",
    "number": "1710612239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "711 STATE AVE NE",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985063984",
            "telephone_number": "360-943-0780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711 STATE AVE NE",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985063984",
            "telephone_number": "360-943-0780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FONTA",
        "first_name": "PRINCEWILL",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-07-19",
        "last_updated": "2026-05-19",
        "certification_date": "2026-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "DE",
            "license": "L8-0010342",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WA",
            "license": "AP70059722",
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MA",
            "license": "RN2307255",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julie J. Fogliano, MSW
• Arthur Lee Foley III, M.D.
• Vivian L Folsom, MSS
• Meghan Fonken, PA-C
• Jutta Fonseca, MA61091263
• Larry L Fontanilla Jr., MD
• Ahmad Fora, MD
• Forest Shores Capital
• Imanie Marie Forest, RN
• Elizabeth Forman Serdar, ARNP

• Psychiatric/Mental Health Nurse Practitioner in Olympia, WA
• Providers in Olympia, WA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2026; 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.