Mickey Joe Fuller, MA, MS, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

5329261-2501 Issued in UT

Practice address

377 E Riverside Dr Ste B
St George, UT 84790-4749

Phone

(435) 862-8273

Fax

(435) 275-4256

NPI assigned

Mar 18, 2006

Last updated

Aug 26, 2026By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Mick Fuller Professional name

Medicare fee-for-service enrollment

Enrolled in UT

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

Credentials

Master of Arts, Master of Science

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Therapy Associates, PC

  • Community/Behavioral Health Agency
  • St George, UT
  • NPI 1578703468

  Addiction (Substance Use Disorder)

  Medicare reassignment NPD
• Four Corners Community Behavioral Health Inc

  dba Operation Recovery

  • Methadone Clinic
  • Price, UT
  • NPI 1164048492
  NPD (past)
• Four Corners Community Behavioral Health, Inc.

  • Community/Behavioral Health Agency
  • Price, UT
  • NPI 1487715330
  NPD (past)

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

{
    "created_epoch": "1142640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787702400000",
    "number": "1427017573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "377 E RIVERSIDE DR STE B",
            "city": "ST GEORGE",
            "state": "UT",
            "postal_code": "847904749",
            "telephone_number": "435-862-8273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "377 E RIVERSIDE DR STE B",
            "city": "ST GEORGE",
            "state": "UT",
            "postal_code": "847904749",
            "telephone_number": "435-862-8273",
            "fax_number": "435-275-4256"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLER",
        "first_name": "MICKEY",
        "middle_name": "JOE",
        "name_prefix": "Dr.",
        "credential": "MA, MS, PSY.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-18",
        "last_updated": "2026-08-26",
        "certification_date": "2026-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "UT",
            "license": "5329261-2501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICK",
            "last_name": "FULLER",
            "prefix": "DR.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Silvia Yang Fuente Perez
• Mayuni Fuentes
• McKenna Jolie Fukuda
• Full Circle Psychiatry and Mental Health
• Clayton G Fuller, MD
• Baylee Fullmer
• Alexis Marie Fulton
• Kimberely Funk
• Brittani Furnival
• Fusion Pharmacy LLC (Fusion Pharmacy)

• Clinical Psychologist in St George, UT
• Providers in St George, UT by specialty
• Clinical Psychologist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2026; 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.