Ilea Fuller, LPC, CAADC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

C-03721 Issued in MI

Practice address

540 Depot St
Hancock, MI 49930-2031

Phone

(906) 482-7282

NPI assigned

May 2, 2017

Last updated

Apr 9, 2024By 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

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.

• Great Lakes Recovery Centers

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Hancock, MI
  • NPI 1023493152
  NPD (past)
• Great Lakes Recovery Centers

  • Substance Abuse Rehabilitation Facility
  • Ironwood, MI
  • NPI 1821267956
  NPD (past)

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

{
    "created_epoch": "1493683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712620800000",
    "number": "1467988170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25901 E PINE ST",
            "city": "CALUMET",
            "state": "MI",
            "postal_code": "499131257",
            "telephone_number": "906-369-3949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "540 DEPOT ST",
            "city": "HANCOCK",
            "state": "MI",
            "postal_code": "499302031",
            "telephone_number": "906-482-7282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLER",
        "first_name": "ILEA",
        "credential": "LPC, CAADC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-02",
        "last_updated": "2024-04-09",
        "certification_date": "2024-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MI",
            "license": "C-03721",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MI",
            "license": "6401019086",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah Anne Fosco, PA-C
• Judy Diane Foster, PTA
• Jayne Ann Fredrick, LMSW
• Zachary Paul French, MD
• Freshwater Counseling Services LLC
• Edward Guy Furst, LPC, LMFT
• Christy Lee Girard, PSYD
• Donna Marie Gladden-Ex, RPH
• Jessica Lee Gostlin, MA LLP
• Carol A Grafford, RD, CDE

• Addiction (Substance Use Disorder) Counselor in Hancock, MI
• Providers in Hancock, MI by specialty
• Addiction (Substance Use Disorder) Counselor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2024; 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.