Tanya Fountain LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

TANYA FOUNTAIN LLC

Practice address

780 Commercial St SE Ste 201
Salem, OR 97301-3463

Phone

(971) 599-3881

Fax

(503) 300-2848

NPI assigned

Nov 19, 2024

Organization subpart

No

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

Authorized official

Name

Tanya Fountain, LCSWNPI 1235338559

Title

Clinical Social Worker/ Therapist

Phone

(971) 599-3881

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

Practitioners 1

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

• Tanya Rose Fountain

  • Clinical Social Worker
  • Salem, OR
  • NPI 1235338559
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1731974400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731974400000",
    "number": "1942025598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "780 COMMERCIAL ST SE STE 201",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973013463",
            "telephone_number": "971-599-3881",
            "fax_number": "503-300-2848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "780 COMMERCIAL ST SE STE 201",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973013463",
            "telephone_number": "971-599-3881",
            "fax_number": "503-300-2848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TANYA FOUNTAIN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-19",
        "last_updated": "2024-11-19",
        "certification_date": "2024-11-19",
        "status": "A",
        "authorized_official_last_name": "FOUNTAIN",
        "authorized_official_first_name": "TANYA",
        "authorized_official_title_or_position": "CLINICAL SOCIAL WORKER/ THERAPIST",
        "authorized_official_telephone_number": "971-599-3881",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Henry Tang
• Robin Anne Tangredi, MS FNP-C.
• Amy L Tanikawa, LPC, NCC
• Laura Christine Tanner
• Matthew Tanner, PHARM.D.
• William I Tapley, COUNSELOR
• Tiffera Rozzelle Tarbox
• Christopher James Tarozzi
• Darcy S Tataryn, MSPT
• Gina Tataryn, LMT

• Clinical Social Worker in Salem, OR
• Providers in Salem, OR by specialty
• Clinical Social Worker in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.