Individual provider Active NPI

Robyn Joyce Fullerton, M.A., LPC

  • Professional Counselor
  • Muskogee, OK
National Provider Identifier
1255667622
Registry record updated Oct 20, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
4049 Issued in OK
Practice address
1305 S County Club Rd
Muskogee, OK 74403-7802
Phone
(918) 686-5588
NPI assigned
Oct 20, 2009
Last updated
Oct 20, 2009By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 20, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 4049 OK Primary

Addresses

Primary practice location

1305 S County Club Rd
Muskogee, OK 74403-7802

Mailing address

519 Valhalla Dr
Muskogee, OK 74403-8517

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
Credentials
Master of Arts

NPI Registry JSON

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

{
    "created_epoch": "1255996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1255996800000",
    "number": "1255667622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "519 VALHALLA DR",
            "city": "MUSKOGEE",
            "state": "OK",
            "postal_code": "744038517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1305 S COUNTY CLUB RD",
            "city": "MUSKOGEE",
            "state": "OK",
            "postal_code": "744037802",
            "telephone_number": "918-686-5588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLERTON",
        "first_name": "ROBYN",
        "middle_name": "JOYCE",
        "credential": "M.A., LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-10-20",
        "last_updated": "2009-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OK",
            "license": "4049",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Muskogee, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2009; 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.