Active NPI
Suzanne Fulkerson, LMHC, LMFT
- Marriage & Family Therapist
- Bloomington, IN
National Provider Identifier
1144435678
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 35000589A
- Practice address
- 205 N College Ave
Suite 613
Bloomington, IN 47404-3950 - Phone
- (812) 334-2858
- NPI assigned
- May 10, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 39000832A | IN | |
| Marriage & Family Therapist | 106H00000X | 35000589A | IN | Primary |
Addresses
Primary practice location
205 N College Ave
Suite 613
Bloomington, IN 47404-3950
Mailing address
205 N College Ave
Suite 613
Bloomington, IN 47404-3950
Phone (812) 334-2858
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 39000832A | IN | MD | Mental Health Counselor |
| 35000589A | IN | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178755200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1757548800000",
"number": "1144435678",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "205 N COLLEGE AVE",
"address_2": "SUITE 613",
"city": "BLOOMINGTON",
"state": "IN",
"postal_code": "474043950",
"telephone_number": "812-334-2858"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "205 N COLLEGE AVE",
"address_2": "SUITE 613",
"city": "BLOOMINGTON",
"state": "IN",
"postal_code": "474043950",
"telephone_number": "812-334-2858"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FULKERSON",
"first_name": "SUZANNE",
"credential": "LMHC, LMFT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-05-10",
"last_updated": "2025-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "IN",
"license": "39000832A",
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "IN",
"license": "35000589A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bloomington, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.