Teea R Fullen-Barnes, LPCA, LAT, ATC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

280487 Issued in KY

Practice address

6500 Glenridge Park PL Ste 8
Louisville, KY 40222-3450

Phone

(502) 303-2449

NPI assigned

Feb 8, 2019

Reactivated

Aug 31, 2023

Last updated

Sep 6, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• Bloom Counseling and Wellness, LLC

  • Professional Counselor
  • Louisville, KY
  • NPI 1124614177

  Mental Health

  NPD
• Innovative Solutions R & D LLC

  dba Congruence in Care

  • Nurse Practitioner
  • Somerset, KY
  • NPI 1952875924
  NPD (past)

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

{
    "created_epoch": "1549584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693958400000",
    "number": "1457816977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "341 CUNNINGHAM LN",
            "city": "WINCHESTER",
            "state": "KY",
            "postal_code": "403917450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6500 GLENRIDGE PARK PL STE 8",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402223450",
            "telephone_number": "502-303-2449"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "600 Monticello St",
            "address_purpose": "LOCATION",
            "city": "Somerset",
            "state": "KY",
            "postal_code": "425012974",
            "country_code": "US",
            "telephone_number": "606-401-2966",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FULLEN-BARNES",
        "first_name": "TEEA",
        "middle_name": "R",
        "credential": "LPCA, LAT, ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-08",
        "last_updated": "2023-09-06",
        "certification_date": "2023-09-06",
        "deactivation_date": "2020-11-14",
        "reactivation_date": "2023-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "KY",
            "license": "280487",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tara Fulkerson
• Katelyn Lacy Fulks
• Sarah S Fulks, MD
• Full Circle Integrative Healing
• Full Range Early Intervention Services LLC
• Madison Eubanks Fullen, PT DPT
• Fuller Rehabilitation and Consulting Services Inc. (Fuller Rehabilitation)
• Alanah Fuller
• Alecia Fuller
• Haley Fuller, MD

• Mental Health Counselor in Louisville, KY
• Providers in Louisville, KY by specialty
• Mental Health Counselor in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2023; 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.