Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Fountain Therapeutic and Supportive Services LLC

Organization Clinical Social Worker · NPI 1285959312

Fountain Therapeutic and Supportive Services LLC is a Clinical Social Worker in Jacksonville, North Carolina. Licensed in District of Columbia. Registered with an NPI since 2010.

Licensed in
DC
In the registry since
2010
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

108 Cardiff Ct # CY
Jacksonville, NC 28546-7864
Phone: (301) 437-9666
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence LC50078852 (DC)

Record details

NPI number1285959312
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Janny Jinor — Manager · (301) 437-9666
Other names Miralife Health Services
NPI enumeratedMarch 31, 2010
Last updated in NPPESFebruary 11, 2015
Mailing address108 Cardiff Ct, Jacksonville, NC 28546-7864

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