Active NPI
Alexander D Fuller, MA, LPC
- Mental Health Counselor
- Louisville, CO
National Provider Identifier
1205966546
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 824 Pine St Ste 106
Louisville, CO 80027-1836 - Phone
- (720) 352-3594
- NPI assigned
- Mar 6, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | Primary |
Addresses
Primary practice location
824 Pine St Ste 106
Louisville, CO 80027-1836
Mailing address
824 Pine St Ste 106
Louisville, CO 80027-1836
Phone (720) 352-3594
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 084-520493 | Other | CO | EMPLOYER IDENTIFICATION |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CO
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Mental Health Counselor
- Education
- Other, 2005
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
PO Box
Dallas, TX 75373
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Arts
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sondermind Provider Network LLC | Professional | Current | Accepting new patients |
Locations
720 S Colorado Blvd
Ph N
Glendale, CO 80246
Phone (833) 988-0589
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": "1173139200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1742515200000",
"number": "1205966546",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "824 PINE ST STE 106",
"city": "LOUISVILLE",
"state": "CO",
"postal_code": "800271836",
"telephone_number": "720-352-3594"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "824 PINE ST STE 106",
"city": "LOUISVILLE",
"state": "CO",
"postal_code": "800271836",
"telephone_number": "720-352-3594"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FULLER",
"first_name": "ALEXANDER",
"middle_name": "D",
"credential": "MA, LPC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-03-06",
"last_updated": "2025-03-21",
"certification_date": "2025-03-21",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "EMPLOYER IDENTIFICATION",
"identifier": "084-520493",
"state": "CO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Louisville, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.