Bernita Wynn Fuller, LLPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

L928846 Issued in MI

Practice address

806 Tuuri PL
Flint, MI 48503-2465

Phone

(810) 767-5750

NPI assigned

Jan 10, 2007

Last updated

Jul 8, 2007By the provider in NPPES

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

Enrolled in MI

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

Specialty

Mental Health Counselor

Education

Other, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Blue Water Mental Health ClinicGroup PAC ID 2769477264, 23 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Blue Water Mental Health Clinic

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Fort Gratiot, MI
  • NPI 1457305419
  Medicare reassignment Care Compare group
• Concepts in Counseling L.L.C.

  • Clinical Social Worker
  • Lapeer, MI
  • NPI 1609827245
  NPD (past)
• Lapeer Christian Counseling, LLC

  • Clinical Social Worker
  • Lapeer, MI
  • NPI 1134789837

  Professional

  NPD (past)

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

{
    "created_epoch": "1168387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1427107002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1303 HORIZON DR",
            "city": "LAPEER",
            "state": "MI",
            "postal_code": "484468663",
            "telephone_number": "810-767-5750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "806 TUURI PL",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485032465",
            "telephone_number": "810-767-5750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLER",
        "first_name": "BERNITA",
        "middle_name": "WYNN",
        "credential": "LLPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "L928846",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leiv A Fry, LMSW
• Shawn A. Fryzel, CRNA
• Korrina Fudge, MD
• Nicole J Fuglseth, LPN,CNA
• Bernadette Lynn Fulco, RN
• Mikah Javay Fuller
• Whitney Kay Fuller
• Alyssa Fulton-Steinard
• Harry Jeffery Fulton, LMSW
• Kalaya Marie Funches

• Professional Counselor in Flint, MI
• Providers in Flint, MI by specialty
• Professional Counselor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.