Individual provider Active NPI

Lynnette Yvette Fuller, LMHC

  • Mental Health Counselor
  • Miami, FL
National Provider Identifier
1154520120
Registry record updated Jul 25, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH6550 Issued in FL
Practice address
9010 SW 137TH Ave
Suite 202
Miami, FL 33186-1413
Phone
(305) 385-0066
Fax
(305) 385-0106
NPI assigned
Jul 11, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 25, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X MH6550 FL Primary

Addresses

Primary practice location

9010 SW 137TH Ave
Suite 202
Miami, FL 33186-1413

Mailing address

9010 SW 137TH Ave
Suite 202
Miami, FL 33186-1413
Phone (305) 385-0066

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

LicenseStateTypeSpecialty
MH6550FLMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Restore Counseling Services Current Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1184112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280016000000",
    "number": "1154520120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9010 SW 137TH AVE",
            "address_2": "SUITE 202",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331861413",
            "telephone_number": "305-385-0066",
            "fax_number": "305-385-0106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9010 SW 137TH AVE",
            "address_2": "SUITE 202",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331861413",
            "telephone_number": "305-385-0066",
            "fax_number": "305-385-0106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLER",
        "first_name": "LYNNETTE",
        "middle_name": "YVETTE",
        "name_prefix": "Ms.",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-07-11",
        "last_updated": "2010-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH6550",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.