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KEDEISHA FOUNTAIN
NPI 1184897084
Counselor - Professional in Stratford, CT

Active since April 11, 2008PECOS Enrolled
821 SUCCESS AVE, STRATFORD, CT 06614(475) 243-8875 Get Directions Write a Review

NPPES record last updated: October 12, 2023. Verified against the NPPES registry weekly; last sync: September 06, 2026.

Record update history: Oct 12, 2023, Apr 21, 2022 (2 updates tracked since 2022).

About Kedeisha Fountain NPPES

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

KEDEISHA FOUNTAIN (NPI 1184897084) is an individual professional provider in Stratford, Connecticut and active in the NPI registry since April 2008. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1184897084
Entity TypeIndividualFemale
Primary Taxonomy101YP2500X
Provider Legal NameKEDEISHA FOUNTAIN
Location Address821 SUCCESS AVEStratford, CT 06614-3731
Mailing Address18 Cadbury PlaceNaugatuck, CT 06770 · (475) 243-8875
Phone(475) 243-8875
Sole ProprietorNo
Enumeration DateApril 11, 2008
Last NPPES UpdateOctober 12, 20232 updates tracked since enumeration
NPPES CertifiedOctober 12, 2023
✔ NPI 1184897084 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers
Taxonomy Code101YP2500X
821 SUCCESS AVE, Stratford, CT 06614
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Providence Health Plan.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kedeisha Fountain is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES

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

MIND AFTER MIND INC
Counselor (Professional)
821 SUCCESS AVE
STRATFORD, CT 06614
Greater Bridgeport Planning Region (475) 243-8875

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 Kedeisha Fountain's NPI number?

The NPI number for Kedeisha Fountain is 1184897084. It was assigned to this individual provider in the NPPES registry on April 11, 2008.

Where is Kedeisha Fountain located?

Kedeisha Fountain practices at 821 Success Ave, Stratford, CT 06614. The listed phone number is (475) 243-8875.

What is Kedeisha Fountain's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

Is Kedeisha Fountain enrolled in Medicare?

Yes. Kedeisha Fountain is registered in the Medicare PECOS enrollment system.

What insurance does Kedeisha Fountain accept?

Health plans from Providence Health Plan list Kedeisha Fountain as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Kedeisha Fountain was last updated on October 12, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.