Kedeisha Fountain, in Stratford, CT - Medicare Counselor Provider

Kedeisha Fountain, is a medicare enrolled "Counselor - Professional" provider in Stratford, Connecticut. Her current practice location is 821 Success Ave, Stratford, Connecticut. You can reach out to her office (for appointments etc.) via phone at (475) 243-8875.

Kedeisha Fountain is licensed to practice in * (Not Available) (license number ) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1184897084.

Contact Information

	Kedeisha Fountain,
	821 Success Ave, Stratford, CT 06614-3731
	(475) 243-8875
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Kedeisha Fountain
Gender	Female
Speciality	Counselor - Professional
Location	821 Success Ave, Stratford, Connecticut
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1184897084
Provider Enumeration Date: 04/11/2008
Last Update Date: 10/12/2023

Medicare PECOS Information:

PECOS PAC ID: 0840642880
Enrollment ID: I20240116001558

Medical Identifiers

Medical identifiers for Kedeisha Fountain such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1184897084	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
101YP2500X	Counselor - Professional	(* (Not Available))	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Kedeisha Fountain allows following entities to bill medicare on her behalf.

Entity Name	Step Up Care Pc Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1154884740 PECOS PAC ID: 5496088346 Enrollment ID: O20190607000156

Entity Name	Mellahealth Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1477158046 PECOS PAC ID: 9032528658 Enrollment ID: O20210512001623

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Kedeisha Fountain is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Kedeisha Fountain, 18 Cadbury Place, Naugatuck, CT 06770 Ph: (475) 243-8875	Kedeisha Fountain, 821 Success Ave, Stratford, CT 06614-3731 Ph: (475) 243-8875

Reviews and Comments

Counselor in Stratford, CT

Frederick Streets, Counselor Medicare: Not Enrolled in Medicare Practice Location: 602 Nichols Ave, Stratford, CT 06614 Phone: 203-296-2430
Lisbeth Ane Greist, LCSW, LPCA Counselor Medicare: Not Enrolled in Medicare Practice Location: 215 Washington Pkwy, Stratford, CT 06615 Phone: 203-522-6023
Mr. John A Pacheco, LCSW, LADC Counselor Medicare: May Accept Medicare Assignments Practice Location: 1825 Barnum Ave, Suite #304, Stratford, CT 06614 Phone: 203-375-5782 Fax: 203-375-3048
Ms. Elizabeth Rose Damon, LPC, R-DMT Counselor Medicare: Not Enrolled in Medicare Practice Location: 4021 Main St, 1f, Stratford, CT 06614 Phone: 207-415-3842
Jacqueline Alexandra Balarezo, MA MENTAL HEALTH Counselor Medicare: Not Enrolled in Medicare Practice Location: 100 Tomlinson Pl, Stratford, CT 06614 Phone: 203-543-0142
Charles James Mead, LPCA Counselor Medicare: Not Enrolled in Medicare Practice Location: 2505 Main St Ste 231, Stratford, CT 06615 Phone: 203-375-5782 Fax: 203-375-3048
Shaquita Junes, Counselor Medicare: Not Enrolled in Medicare Practice Location: 80 Sunrise Ter, Stratford, CT 06614 Phone: 203-650-1155

Kedeisha Fountain, - Medicare Counselor in Stratford, CT