Individual provider Active NPI

Ariyon Fountaine

  • Mental Health Counselor
  • Marlton, NJ
National Provider Identifier
1760008247
Registry record updated Jun 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
44SL06161700 Issued in NJ
Practice address
19 E Main St
Marlton, NJ 08053-2172
Phone
(609) 714-8400
NPI assigned
Jun 22, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 22, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 44SL06161700 NJ Primary

Addresses

Primary practice location

19 E Main St
Marlton, NJ 08053-2172

Mailing address

19 E Main St
Marlton, NJ 08053-2172
Phone (609) 714-8400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
44SL06161700NJMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1592784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592784000000",
    "number": "1760008247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 E MAIN ST",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080532172",
            "telephone_number": "609-714-8400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 E MAIN ST",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080532172",
            "telephone_number": "609-714-8400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOUNTAINE",
        "first_name": "ARIYON",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-06-22",
        "last_updated": "2020-06-22",
        "certification_date": "2020-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NJ",
            "license": "44SL06161700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marlton, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2020; 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.