Jake E Fuller, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

6401226147 Issued in MI

Practice address

142 E Maumee St Ste 3
Adrian, MI 49221-2735

Phone

(312) 718-4221

NPI assigned

Mar 21, 2024

Sex

Male

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, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Acpc PLLCGroup PAC ID 4981947850, 19 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: adriancounselingandpsychiatricclinic.jakefuller@153442.advancedmd-direct.com

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.

• FFC PLLC

  • Professional Counselor
  • Southfield, MI
  • NPI 1821808296

  Mental Health

  Medicare reassignment NPD Authorized official
• Acpc PLLC

  • Physician Assistant
  • Adrian, MI
  • NPI 1831658483
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1710979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776038400000",
    "number": "1477313815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 W SHAWNEE ST",
            "city": "TECUMSEH",
            "state": "MI",
            "postal_code": "492861566",
            "telephone_number": "312-718-4221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "142 E MAUMEE ST STE 3",
            "city": "ADRIAN",
            "state": "MI",
            "postal_code": "492212735",
            "telephone_number": "312-718-4221"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "112 W Shawnee St",
            "address_purpose": "LOCATION",
            "city": "Tecumseh",
            "state": "MI",
            "postal_code": "492861566",
            "country_code": "US",
            "telephone_number": "734-215-5404",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FULLER",
        "first_name": "JAKE",
        "middle_name": "E",
        "name_prefix": "Mr.",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-03-21",
        "last_updated": "2026-04-13",
        "certification_date": "2026-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6401226147",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Austeen Freeman, LMT
• Chelsea Faith Frey, O.D.
• Bruce Howard Fry, CADC
• Michelle Renee Larkin Fulcher, ACSW, LMSW
• Allison Eva Fulgenti
• Amy Ellen Fullerton, MA. LLPC
• Lindsay Marie Galambos, PT, DPT
• Nicole Gallagher
• Denise Gamas Gonzalez
• Tina R Gamble, CMA

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 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.
• 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.