Individual provider Active NPI

Brianne Fulton

  • Professional Counselor
  • Redding, CA
National Provider Identifier
1396186524
Registry record updated Jan 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LPCC4041
Practice address
2640 Breslauer Way
Redding, CA 96001-4246
Phone
(530) 225-5252
NPI assigned
Jul 16, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X LPCC4041 CA
Professional Counselor 101YP2500X LPCC4041 Primary

Addresses

Primary practice location

2640 Breslauer Way
Redding, CA 96001-4246

Mailing address

2640 Breslauer Way
Redding, CA 96001-4246
Phone (530) 225-5252

Other identifiers 1

IdentifierTypeStateIssuer
Y4420942OtherCADRIVER'S LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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

Enrollment IDStateProvider typePAC IDDetails
I20241209003510 CA Practitioner - Mental Health Counselor 8628504032 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2012
Medicare assignment
May accept Medicare assignment
Group practices
Hill Country Community ClinicGroup PAC ID 1052442175, 19 clinicians

Practice addresses (Care Compare)

29632 E Hwy 299
Round Mountain, CA 96084-8000
Phone (530) 337-5750

29632 Hwy 299 E
Round Mountain, CA 96084

PO Box
Suite 228
Round Mountain, CA 96084

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LPCC4041CAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Hill Country Community Clinic Current Accepting new patients
Hill Country Community Clinic CurrentSince Dec 2, 2024 Accepting new patients
Hill Country Community Clinic CurrentSince Dec 2, 2024 Accepting new patients

Locations

3270 Churn Creek Rd
Redding, CA 96002
Phone (530) 222-3287

1401 Gold St
Ste A
Redding, CA 96001
Phone (530) 319-7066

1024 Mistletoe Ln
Ste B
Redding, CA 96002
Phone (530) 232-0845

29632 E Highway 299
Round Mtn, CA 96084
Phone (530) 337-5750

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1373932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611187200000",
    "number": "1396186524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2640 BRESLAUER WAY",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960014246",
            "telephone_number": "530-225-5252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2640 BRESLAUER WAY",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960014246",
            "telephone_number": "530-225-5252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULTON",
        "first_name": "BRIANNE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-16",
        "last_updated": "2021-01-21",
        "certification_date": "2021-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "LPCC4041",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": "LPCC4041",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DRIVER'S LICENSE",
            "identifier": "Y4420942",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Redding, CA

Sources for this page

Verify at the official NPI Registry.