EDDIE FOUNTAIN
NPI 1295182889
Counselor - Mental Health in Tallulah, LA
Active since May 24, 2016
About Eddie Fountain NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
EDDIE FOUNTAIN (NPI 1295182889) is an individual mental health provider in Tallulah, Louisiana and active in the NPI registry since May 2016.
NPPES Registry Identity
NPI1295182889
Entity TypeIndividualMale
Primary Taxonomy101YM0800X
Provider Legal NameEDDIE FOUNTAIN
Location Address1705 FELICIA AVETallulah, LA 71282-8203
Mailing Address1705 Felicia AveTallulah, LA 71282-8203 · (318) 574-1232 · Fax (318) 574-8646
Phone(318) 574-1232
Fax(318) 574-8646
Sole ProprietorYes
Enumeration DateMay 24, 2016
✔ NPI 1295182889 is a valid, active identifier and passes the ISO check-digit test.
Specialties & Licenses
★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
1705 FELICIA AVE, Tallulah, LA 71282
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1295182889, enumerated as an "individual" on May 24, 2016.
The provider is located at 1705 FELICIA AVE TALLULAH, LA 71282 and the phone number is (318) 574-1232.
Counselor with taxonomy code 101YM0800X and a focus in Mental Health.