DR. JOHN E FONTAINE IV PH.D.
NPI 1093818064
Psychologist - Clinical Child & Adolescent in Jackson, MS

Active since September 06, 2006
1855 CRANE RIDGE DR STE A, JACKSON, MS 39216(601) 982-8700(601) 366-3906 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Dr. John E Fontaine Iv Ph.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. JOHN E FONTAINE IV PH.D. (NPI 1093818064) is an individual clinical child & adolescent provider in Jackson, Mississippi, licensed in Mississippi (30429) and active in the NPI registry since September 2006.

NPPES Registry Identity

NPI1093818064
Entity TypeIndividualMale
Primary Taxonomy103TC2200X
Provider Legal NameDR. JOHN E FONTAINE IVCredential: PH.D.
Location Address1855 CRANE RIDGE DR STE AJackson, MS 39216-4944
Mailing Address1855 Crane Ridge Dr Ste AJackson, MS 39216-4944 · (601) 982-8700 · Fax (601) 366-3906
Fax(601) 366-3906
Sole ProprietorYes
Enumeration DateSeptember 6, 2006
Last NPPES UpdateJuly 8, 2007
NPI 1093818064 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPsychologist · Clinical Child & AdolescentBehavioral Health & Social Service Providers
Taxonomy Code103TC2200X
License Licensed in MS · 30429
Definition

A psychologist who develops and applies scientific knowledge to the delivery of psychological services to infants, toddlers, children and adolescents within their social context. Of particular importance to the specialty of clinical child psychology is an understanding of the basic psychological needs of children and adolescents, and how the family and other social contexts influence the socio-emotional adjustment, cognitive development, behavioral adaptation and health status of children and adolescents.

1855 CRANE RIDGE DR STE A, Jackson, MS 39216

Other Identifiers 2

Medicaid00011417MS
Medicare UPINS01466MS

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Counselor (Professional)
1855 CRANE RIDGE DR STE A
JACKSON, MS 39216

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is John Fontaine's NPI number?

The NPI number for John Fontaine is 1093818064. It was assigned to this individual provider in the NPPES registry on September 6, 2006.

Where is John Fontaine located?

John Fontaine practices at 1855 Crane Ridge Dr Ste A, Jackson, MS 39216. The listed phone number is (601) 982-8700.

What is John Fontaine's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical Child & Adolescent, with taxonomy code 103TC2200X.

When was this NPI record last updated?

The NPPES record for John Fontaine was last updated on July 8, 2007. NPI Profile syncs with the weekly NPPES data releases published by CMS.