Lisa Fuller

Primary specialty

CounselorTaxonomy code 101Y00000X

Practice address

1904 Farragut PL
Jacksonville, FL 32207-3420

Phone

(904) 868-0994

NPI assigned

Nov 14, 2024

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

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.

• Tsi Health, LLC

  • Behavior Analyst
  • Jacksonville, FL
  • NPI 1548757693
  NPD
• Tsi Health, LLC

  • Mental Health Counselor
  • Jacksonville, FL
  • NPI 1700592953
  NPD

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

{
    "created_epoch": "1731542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731542400000",
    "number": "1285458315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2534 VICTORIA POINT DR",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322188828",
            "telephone_number": "904-868-0994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1904 FARRAGUT PL",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322073420",
            "telephone_number": "904-868-0994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLER",
        "first_name": "LISA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-11-14",
        "last_updated": "2024-11-14",
        "certification_date": "2024-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christopher Marshall Fuller
• Erica Fuller, OTR/L
• Julie Fuller, LMT
• Keydella Fuller, APN
• Kimberly J Fuller, NP
• Mallory Fuller, M.A.
• Morgan E Fuller
• Jordan D'Ann Fullerton, PA-C
• Shalyn Mackenzie Fullerton, MD
• Hannah Elizabeth Fullford

• Counselor in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2024; 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.