Fullmer Counseling LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

FULLMER COUNSELING LLC

Practice address

545 Shoup Ave
Suite 334
Idaho Falls, ID 83402-3575

Phone

(208) 521-4332

NPI assigned

Sep 27, 2014

Organization subpart

No

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

Authorized official

Name

Mr. Nathan Fullmer, LCPC

Title

Owner

Phone

(208) 521-4332

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1411776000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1411776000000",
    "number": "1275936882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "545 SHOUP AVE",
            "address_2": "SUITE 334",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834023575",
            "telephone_number": "208-521-4332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "545 SHOUP AVE",
            "address_2": "SUITE 334",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834023575",
            "telephone_number": "208-521-4332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FULLMER COUNSELING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-27",
        "last_updated": "2014-09-27",
        "status": "A",
        "authorized_official_last_name": "FULLMER",
        "authorized_official_first_name": "NATHAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-521-4332",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LCPC"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yazmin J Frodin
• Caryl M Frugoli, LCSW LPN EAP
• Full of Life 5580
• Full Spectrum Psychology LLC
• Joshua A Fuller, LPC
• Lorenza Fullmer, M.S., CCC-SLP
• Nathan James Fullmer, LPC
• Annette Fultz, CADC
• Darren Furman, LCSW, PHD
• Vernon O Gaffner, D.M.D.

• Mental Health Clinic/Center (Including Community Mental Health Center) in Idaho Falls, ID
• Providers in Idaho Falls, ID by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2014; 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.