CONRAD FOUNTAINE (LCSW) – Clinical Social Worker, NPI 1316320807

CONRAD FOUNTAINE (LCSW) is a healthcare provider. based in Cherry hill, New Jersey. specializing in CLINICAL SOCIAL WORKER. They hold the professional credentials LCSW. They hold a License No. 44SC00746700 (NJ). The NPI Number for CONRAD FOUNTAINE (LCSW) is 1316320807

Main info

Male
48 Years Of Experience
Name
CONRAD FOUNTAINE (LCSW)
NPI
1316320807
Phone
(856) 816-7114
Address
1930 MARLTON PIKE E STE R91
Enumeration Date
2 July 2015
Last Update Date
2 July 2015

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8567510505
Graduation Year
1978 (48 years ago)
PAC ID
6002113701
Group Practice PAC ID
3173835097
Professional Enrollment ID
I20160323002102
Address ID
NJ080034207CH1930XEXXX405
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience34
Completeness75
Years active:10State licenses:1Digital endpointsOther names

2,724 CLINICAL SOCIAL WORKER in NJ

Provider Addresses for CONRAD FOUNTAINE (LCSW)

  • 1930 MARLTON PIKE E STE R91

    CHERRY HILL, NJ 080034207

    Phone: (856) 816-7114

    Fax: (856) 751-0505

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2016-03-23

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20160323002102IClinical Social WorkerNJTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 08003)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 3173835097View full group profile
NameSpecialtyState
-NJ
-NJ
-NJ
Mental Health CounselorNJ
Clinical Social WorkerNJ
Mental Health CounselorNJ
Clinical Social WorkerNJ
Clinical Social WorkerNJ
-NJ
Clinical Social WorkerNJ

Reviews

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Frequently asked questions

What NPI should I save for CONRAD FOUNTAINE (LCSW)?
Save NPI 1316320807 if you need a stable reference for CONRAD FOUNTAINE (LCSW).
Is CONRAD FOUNTAINE (LCSW) active in the national directory?
CONRAD FOUNTAINE (LCSW)'s public NPI profile is in an active state.
What field does CONRAD FOUNTAINE (LCSW) work in?
You can think of CONRAD FOUNTAINE (LCSW) as practicing within Clinical Social Worker. Clinical services aligned with this taxonomy classification.
Where does public data place CONRAD FOUNTAINE (LCSW)?
The snapshot lists Cherry Hill, New Jersey for CONRAD FOUNTAINE (LCSW); download NPPES for the complete set.
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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