Healthcare Provider Details

I. General information

NPI: 1619808599
Provider Name (Legal Business Name): FOUNTAIN COUNSELING, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/28/2026
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

414 PARKSIDE PL
ZEBULON NC
27597-2152
US

IV. Provider business mailing address

200 E GANNON AVE UNIT A220
ZEBULON NC
27597-2704
US

V. Phone/Fax

Practice location:
  • Phone: 919-375-3006
  • Fax: 919-375-3772
Mailing address:
  • Phone: 919-375-3006
  • Fax: 919-375-3772

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: SUZANNE CAUSEY SIMS
Title or Position: OWNER/MEMBER
Credential: MS, LCMHC, CPTT
Phone: 919-375-3006