Jennifer Stam Fountain, BCBA, LBA
Behavior Analyst in Kirksville, MO. Individual provider (NPI-1).
NPI number1942010673
StatusActive
Last updated in NPPESJan 14, 2025
Details
- NPI
- 1942010673
- Entity type
- Individual (NPI-1)
- Name
- Jennifer Stam Fountain
- Credential
- BCBA, LBA
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jan 14, 2025
- Certification date
- Jan 14, 2025
- Last updated
- Jan 14, 2025
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 103K00000X | Behavior Analyst | 2024007670 | MO | Yes |
Practice location
606 S Halliburton StKirksville, MO 63501-3712
Phone 660-785-7551
Mailing address
807 Greenway DrKirksville, MO 63501-2027
Phone 660-341-2686
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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All 11 Behavior Analyst providers in Kirksville · All 905 providers in Kirksville
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