Fuller Life Institute

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

201031 Issued in TX

Legal business name

FULLER LIFE INSTITUTE

Doing business as

Fuller Life Family Therapy Insitute

Practice address

4545 Bissonnet St Ste 289
Bellaire, TX 77401-3112

Phone

(855) 245-5433

Fax

(855) 245-5433

NPI assigned

Apr 6, 2012

Last updated

Apr 6, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Amy Fuller, PHD, LMFT, LPCNPI 1184730756

Title

Clinical Director

Phone

(855) 245-5433

Specialties & licenses 1

Addresses

Other names 1

• Fuller Life Family Therapy Insitute Doing business as

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Chantail Banks Green

  • Mental Health Counselor
  • Houston, TX
  • NPI 1851018048
  Medicare reassignment NPD
• Dormetra Ann Henry, LPC

  • Professional Counselor
  • Bellaire, TX
  • NPI 1558079681
  Medicare reassignment NPD
• Amy M Fuller, PHD

  • Professional Counselor
  • San Antonio, TX
  • NPI 1184730756
  NPD Authorized official
• Riya Roney Vettickal

  • Professional Counselor
  • Bellaire, TX
  • NPI 1417725417
  NPD

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

{
    "created_epoch": "1333670400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1333670400000",
    "number": "1316203029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4545 BISSONNET ST STE 289",
            "city": "BELLAIRE",
            "state": "TX",
            "postal_code": "774013112",
            "telephone_number": "855-245-5433",
            "fax_number": "855-245-5433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4545 BISSONNET ST STE 289",
            "city": "BELLAIRE",
            "state": "TX",
            "postal_code": "774013112",
            "telephone_number": "855-245-5433",
            "fax_number": "855-245-5433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FULLER LIFE INSTITUTE",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-06",
        "last_updated": "2012-04-06",
        "status": "A",
        "authorized_official_last_name": "FULLER",
        "authorized_official_first_name": "AMY",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "855-245-5433",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD, LMFT, LPC"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "TX",
            "license": "201031",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fuller Life Family Therapy Insitute",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kathy Ann Frazar, DDS
• Donna Marie Freeman, LMT
• Shirley Friedman, EDD
• Mark Frnka, DDS
• Sarah Fuchs
• Courtney Fuller, CNP/FNP
• Laura 'Ginny' Fullerton, PH.D.
• Steven Matthew Fung-on, PA-C
• Abdel Kader Fustok, MD
• Gail L Burleson (Ultrasound Specialists)

• Marriage & Family Therapist in Bellaire, TX
• Providers in Bellaire, TX by specialty
• Marriage & Family Therapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.