Jennifer Stam Fountain, BCBA, LBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

2024007670 Issued in MO

Practice address

606 S Halliburton St
Kirksville, MO 63501-3712

Phone

(660) 785-7551

NPI assigned

Jan 14, 2025

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

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.

• Truman State University

  • Behavior Analyst
  • Kirksville, MO
  • NPI 1578890869
  NPD

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

{
    "created_epoch": "1736812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736812800000",
    "number": "1942010673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "807 GREENWAY DR",
            "city": "KIRKSVILLE",
            "state": "MO",
            "postal_code": "635012027",
            "telephone_number": "660-341-2686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "606 S HALLIBURTON ST",
            "city": "KIRKSVILLE",
            "state": "MO",
            "postal_code": "635013712",
            "telephone_number": "660-785-7551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAM FOUNTAIN",
        "first_name": "JENNIFER",
        "credential": "BCBA, LBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-01-14",
        "last_updated": "2025-01-14",
        "certification_date": "2025-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "MO",
            "license": "2024007670",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Speech-Language and Learning Services LLC
• David Vincent Spencer, DO
• Brooke April Sprague, FNP-C
• SRS- Kirksville LLC
• Lacey Brianne St. Clair, RDH
• State of Missouri
• State of Missouri
• Sarah L Steele, RN
• Karina Stepp
• Katie Lynn Sternberg, MSN, FNP-BC

• All providers in Kirksville, MO
• Behavior Analyst in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 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.