Organization Active NPI

Fountain City Counseling Services

  • Mental Health Counselor
  • Columbus, GA
National Provider Identifier
1811644677
Registry record updated Mar 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
FOUNTAIN CITY COUNSELING SERVICES
Practice address
1661 13TH St Ste 102
Columbus, GA 31901-3844
Phone
(706) 580-4868
NPI assigned
Mar 2, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2022

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

Authorized official

Name
Rochelle Petermann, MS, LPC, CCMHCNPI 1295248094
Title
Licensed Professional Counselor
Phone
(706) 580-9122

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X Primary

Addresses

Primary practice location

1661 13TH St Ste 102
Columbus, GA 31901-3844

Mailing address

2751 Sawgrass LN
Phenix City, AL 36867-2038
Phone (706) 580-9122

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL fountaincitycounselingservices@gmail.com

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1646179200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1646179200000",
    "number": "1811644677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2751 SAWGRASS LN",
            "city": "PHENIX CITY",
            "state": "AL",
            "postal_code": "368672038",
            "telephone_number": "706-580-9122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1661 13TH ST STE 102",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319013844",
            "telephone_number": "706-580-4868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOUNTAIN CITY COUNSELING SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-02",
        "last_updated": "2022-03-02",
        "certification_date": "2022-03-02",
        "status": "A",
        "authorized_official_last_name": "PETERMANN",
        "authorized_official_first_name": "ROCHELLE",
        "authorized_official_title_or_position": "LICENSED PROFESSIONAL COUNSELOR",
        "authorized_official_telephone_number": "706-580-9122",
        "authorized_official_credential": "MS, LPC, CCMHC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "fountaincitycounselingservices@gmail.com",
            "affiliation": "N",
            "address_1": "1661 13th St Ste 102",
            "city": "Columbus",
            "state": "GA",
            "country_code": "US",
            "postal_code": "319013844",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Columbus, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2022; 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.