Jerrica Fuller, MA, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

6401014554 Issued in MI

Practice address

11 Green St
Battle Creek, MI 49014-4028

Phone

(269) 419-1753

NPI assigned

Jul 13, 2015

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

Interoperability endpoints

• Direct secure messaging: jerrica.fuller.1@14940.direct.athenahealth.com

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

{
    "created_epoch": "1436745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662508800000",
    "number": "1205210952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "74 ROOSEVELT AVE W",
            "city": "BATTLE CREEK",
            "state": "MI",
            "postal_code": "490372428",
            "telephone_number": "269-419-1753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 GREEN ST",
            "city": "BATTLE CREEK",
            "state": "MI",
            "postal_code": "490144028",
            "telephone_number": "269-419-1753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLER",
        "first_name": "JERRICA",
        "credential": "MA, LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-07-13",
        "last_updated": "2022-09-07",
        "certification_date": "2022-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6401014554",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William Joseph Fritsch, RPH
• Lauren Frye, PHD
• Samantha Kay Fulkerson, LMSW
• Full Sail Partners, LLC
• Jeremy Lynn Fuller, FNP-C
• Jermaine Funderburg
• Barbara Ellen Funk, MA LPC CAADC
• Alan Michel Furlan, MD
• G&O Enterprise LLC
• Earl E Gaball, DDS

• Professional Counselor in Battle Creek, MI
• Providers in Battle Creek, MI by specialty
• Professional Counselor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2022; 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.