Provider Demographics
NPI:1760715684
Name:FOUNTAIN COUNSELING AND DEVELOPMENTAL SERVICES
Entity type:Organization
Organization Name:FOUNTAIN COUNSELING AND DEVELOPMENTAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AKONDAYE
Authorized Official - Middle Name:SAVONDA
Authorized Official - Last Name:TURNER-FOUNTAIN
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:713-465-4194
Mailing Address - Street 1:10575 KATY FWY STE 428
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024-1023
Mailing Address - Country:US
Mailing Address - Phone:713-465-4194
Mailing Address - Fax:
Practice Address - Street 1:10575 KATY FWY STE 428
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77024-1023
Practice Address - Country:US
Practice Address - Phone:713-465-4194
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-09
Last Update Date:2009-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX20215251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health