Bethany Rae Fuller, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

2022003037 Issued in MO

Practice address

260 Clarkson Rd
Ellisville, MO 63011-2245

Phone

(314) 254-3448

NPI assigned

Apr 30, 2025

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1745971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745971200000",
    "number": "1497543102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3931 WYOMING ST",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631163917",
            "telephone_number": "312-505-8141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "260 CLARKSON RD",
            "city": "ELLISVILLE",
            "state": "MO",
            "postal_code": "630112245",
            "telephone_number": "314-254-3448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLER",
        "first_name": "BETHANY",
        "middle_name": "RAE",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-04-30",
        "last_updated": "2025-04-30",
        "certification_date": "2025-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MO",
            "license": "2022003037",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brice Foose, PHARMD
• Dawn M Forbes, FNP
• Jessica P Fraser, LCSW
• Jeremy M Frith, DDS
• Michael Paul Frith, DDS
• Michael Thomas Furey
• Heather Gargis, LPC
• Caryn L Garriga, MD
• Maureen Gehrlein
• Jane Clara Gelfand, D.O.

• Mental Health Counselor in Ellisville, MO
• Providers in Ellisville, MO by specialty
• Mental Health Counselor in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2025; 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.