Provider Demographics
NPI:1891851028
Name:FOUNTAIN, DON (MS, LPC)
Entity Type:Individual
Prefix:MR
First Name:DON
Middle Name:
Last Name:FOUNTAIN
Suffix:
Gender:M
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:983 BRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:COLLEGEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19426-4100
Mailing Address - Country:US
Mailing Address - Phone:610-489-2383
Mailing Address - Fax:
Practice Address - Street 1:2091 E HIGH ST
Practice Address - Street 2:
Practice Address - City:POTTSTOWN
Practice Address - State:PA
Practice Address - Zip Code:19464-3211
Practice Address - Country:US
Practice Address - Phone:610-970-5234
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC004229101Y00000X
PA101YS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101Y00000XBehavioral Health & Social Service ProvidersCounselor
Not Answered101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool