CAMERON FOUNTAIN (NPI# 1801405238) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801405238 |
| Entity Type | Individual |
| Full Name | CAMERON FOUNTAIN |
| Credential | LCDC |
| Practice Address |
612 N Story Rd Ste 101 Irving TX 75061-6764 |
| Mailing Address |
8109 Skillman St Apt 3008 Dallas TX 75231-2828 |
| Practice Telephone | 4697082955 |
| Enumeration Date | 2020-07-31 |
| Last Update Date | 2020-07-31 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
TX | Behavioral Health & Social Service Providers |
| Street Address |
612 N STORY RD STE 101 |
| City | IRVING |
| State | TX |
| Zip Code | 75061-6764 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629578133 | Bree Bozeman | Counselor | 612 N Story Rd Ste 101, Irving, TX 75061-6764 | 2018-02-20 |
| 1588282032 | Rebirth Inc. | Counselor | 612 N Story Rd Ste 101, Irving, TX 75061-6764 | 2020-07-10 |
| 1689159089 | Rays of Healing Counseling Center | Counselor | 612 N Story Rd Ste 101, Irving, TX 75061-6764 | 2018-10-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265925192 | Health Texas Provider Network | Durable Medical Equipment & Medical Supplies | 2021 N Macarthur Blvd Ste 300, Irving, TX 75061 | 2018-06-14 |
| 1356864722 | Candace Leann Mullens | Physician Assistant | 2005 West Park Dr., Ste. 100, Irving, TX 75061 | 2017-07-18 |
| 1922489541 | Azmat Shah | Clinical Medical Laboratory | 813 N. O'connor Road, Irving, TX 75061 | 2015-06-10 |
| 1689060261 | James Justin Walker | Specialist/Technologist | 900 O'connor Road, Irving, TX 75061 | 2015-04-10 |
| 1790171379 | Casey Elder | Specialist/Technologist | 900 North O'connor, Irving, TX 75061 | 2015-04-10 |
| 1720479900 | Jack C Lewis Jr. | Counselor | 4120 Hackmore Loop, Irving, TX 75061 | 2015-02-10 |
| 1972931186 | Linda Kottoor | Nurse Practitioner | 1800 North Britain Road, Irving, TX 75061 | 2013-10-24 |
| 1033457080 | Edel H Cruz Rosales | Hearing Instrument Specialist | 613 North O'connor Rd, Suite 29, Irving, TX 75061 | 2013-01-26 |
| 1346520293 | Tau Healing Services | Counselor | 1615 Cooper Dr., Irving, TX 75061 | 2011-08-24 |
| 1144520412 | Gibson Pharmacy | Pharmacy | 815 N. Oconnor, Irving, TX 75061 | 2010-11-02 |
| Find all providers in zip 75061 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467071639 | Regina Marie Stiffler | Counselor | 214 Santa Fe Trl Apt 3055, Irving, TX 75063-7162 | 2020-04-08 |
| 1639577653 | Maureen Killoran | Counselor | 3317 Finley Rd Ste 120b, Irving, TX 75062-8722 | 2014-12-08 |
| 1760886501 | Stephen Tomutsa | Counselor | 3317 Finley Rd Ste 120c, Irving, TX 75062-8722 | 2014-10-21 |
| 1184919839 | Andrew Gill | Counselor | 1615 Cooper Dr, Irving, TX 75061-3026 | 2011-06-10 |
| 1043219504 | Adrienne Garcia-o'malley | Counselor | 2912 N Macarthur Blvd, Ste. 107, Irving, TX 75062-4447 | 2005-07-18 |
| 1689234668 | Heidi Lynne Kazmark | Counselor | 36 Thomas Indian School Dr, Irving, NY 14081-9300 | 2019-06-20 |
| 1952846917 | Crystal Leigh Kawski | Counselor | 36 Thomas Indian School Dr, Irving, NY 14081-9300 | 2016-12-30 |
| 1245786334 | Lori C Snell | Counselor | 3317 Finley Rd, Suite 168, Irving, TX 75062-8722 | 2016-08-29 |
| 1225412539 | Stephen Tomutsa | Counselor | 3317 Finley Rd, Ste 120c, Irving, TX 75062-8722 | 2015-07-16 |
| 1194105122 | Gwen L Hodrick | Counselor | 3317 Finley Rd Ste 120c, Irving, TX 75062-8722 | 2015-06-04 |
| Find all providers in IRVING | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.