Andreya Fountain, SUDPT

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

60985197 Issued in WA

Practice address

2156 Pacific Ave
Tacoma, WA 98402-3004

Phone

(253) 200-0505

Fax

(253) 200-0636

NPI assigned

Nov 18, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Bayview Recovery LLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Tacoma, WA
  • NPI 1396223640
  NPD (past)

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

{
    "created_epoch": "1605657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605657600000",
    "number": "1821691130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2156 PACIFIC AVE",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984023004",
            "telephone_number": "253-200-0505",
            "fax_number": "253-200-0636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2156 PACIFIC AVE",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984023004",
            "telephone_number": "253-200-0505",
            "fax_number": "253-200-0636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOUNTAIN",
        "first_name": "ANDREYA",
        "credential": "SUDPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-18",
        "last_updated": "2020-11-18",
        "certification_date": "2020-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WA",
            "license": "60985197",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Terri Guesman Foster, PHARMD
• Alisha Marie Fouch, LPN
• Foundation for Multicultural Solutions/ El Camino Program
• Foundational Roots Therapy and Consulting
• Fountain of Life Wellness Center
• Naomi Janeva Fountain
• Jackie Michelle Fournier, MSW, LICSW
• Alyssa Fouts
• Kelli Marie Fouts
• John Fowler, MD

• Addiction (Substance Use Disorder) Counselor in Tacoma, WA
• Providers in Tacoma, WA by specialty
• Addiction (Substance Use Disorder) Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 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.