Joann Fuller

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

XL3862 Issued in ME

Practice address

470 Forest Ave
Suite 202
Portland, ME 04101

Phone

(207) 774-3570

Fax

(207) 774-3540

NPI assigned

Dec 30, 2011

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

Enrolled in ME

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Sweetser

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Saco, ME
  • NPI 1538122445
  Medicare reassignment NPD

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

{
    "created_epoch": "1325203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1325203200000",
    "number": "1275803702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "179 PEPPERRELL RD",
            "city": "KITTERY POINT",
            "state": "ME",
            "postal_code": "039055114",
            "telephone_number": "207-439-9160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "470 FOREST AVE",
            "address_2": "SUITE 202",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "04101",
            "telephone_number": "207-774-3570",
            "fax_number": "207-774-3540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLER",
        "first_name": "JOANN",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-12-30",
        "last_updated": "2011-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "ME",
            "license": "XL3862",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ruth Frydman, MD
• Alfred Fuamba
• Debra A Fuchs Ertman, MD
• Stepfany Fuentes, DO
• Heidi Marie Fuller, CRNA
• Melissa Fuller
• Timothy Fuller, LCSW
• Valerie J Fuller, RN, FNP-C
• David Fulmer, CRNA
• Angus Fung, DO

• Mental Health Counselor in Portland, ME
• Providers in Portland, ME by specialty
• Mental Health Counselor in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2011; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.