Brian H Fontaine, CADAC II is a
Counselor - Addiction (substance Use Disorder) based in La Porte, Indiana. Brian H Fontaine is licensed to practice in Indiana (license number C2-5180) and his current practice location is
2125 E 450 S, La Porte, Indiana. He can be reached at his office (for appointments etc.) via phone at
(192) 608-4926.
NPI number for Brian H Fontaine is 1871201152 and his current mailing address is 2125 E 450 S, La Porte, Indiana. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1871201152.
Healthcare Provider's Profile
| Full Name | Brian H Fontaine |
|---|
| Gender | Male |
|---|
| Speciality | Counselor - Addiction (substance Use Disorder) |
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| Location | 2125 E 450 S, La Porte, Indiana |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
|---|
NPI Data:
- NPI Number: 1871201152
- Provider Enumeration Date: 11/07/2022
- Last Update Date: 11/07/2022
Medical Identifiers
Medical identifiers for Brian H Fontaine such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1871201152 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 103TA0400X | Psychologist - Addiction (substance Use Disorder) | C2-5180 (Indiana) | Secondary |
| 106S00000X | Behavior Technician | C2-5180 (Indiana) | Secondary |
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | C2-5180 (Indiana) | Primary |
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. Brian H Fontaine is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Brian H Fontaine, CADAC II
2125 E 450 S,
La Porte, IN 46350-7649
Ph: (192) 608-4926 | Brian H Fontaine, CADAC II
2125 E 450 S,
La Porte, IN 46350-7649
Ph: (192) 608-4926 |
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