Fountain Wellness, LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

FOUNTAIN WELLNESS, LLC

Practice address

3030 S College Ave
Fort Collins, CO 80525-2557

Phone

(720) 310-8731

NPI assigned

Nov 10, 2025

Last updated

Nov 10, 2025By the provider in NPPES

Organization subpart

Yes

Parent organization

FOUNTAIN WELLNESS, LLCAs reported in NPPES

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

Authorized official

Name

Nicole Bleau

Title

Owner

Phone

(720) 310-8731

Specialties & licenses 2

Addresses

Tax ID family

Fountain Wellness LLC2 organizations share this tax ID, including this one

Part of

Fountain Wellness LLC

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Fountain Wellness, LLC

  • Mental Health Counselor
  • Boulder, CO
  • NPI 1710786025
  NPD tax ID

Locations

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Fountain Wellness, LLC

  • Mental Health Counselor
  • Boulder, CO
  • NPI 1710786025
  NPPES parent name

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

{
    "created_epoch": "1762732800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1762732800000",
    "number": "1720958085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2762 CENTER PARK WAY",
            "city": "BERTHOUD",
            "state": "CO",
            "postal_code": "805132712",
            "telephone_number": "720-310-8731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3030 S COLLEGE AVE",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805252557",
            "telephone_number": "720-310-8731"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOUNTAIN WELLNESS, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FOUNTAIN WELLNESS, LLC",
        "enumeration_date": "2025-11-10",
        "last_updated": "2025-11-10",
        "certification_date": "2025-11-10",
        "status": "A",
        "authorized_official_last_name": "BLEAU",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "720-310-8731"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Fort Collins, CO
• Providers in Fort Collins, CO by specialty
• Mental Health Counselor in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.