Michael Eugene Fuller, MS

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

Practice address

1743 Gay Dr
Orlando, FL 32803-1914

Phone

(407) 716-7669

NPI assigned

Aug 11, 2010

Last updated

Apr 11, 2017By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

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.

• Fuller & Associates, LLC

  • Adolescent and Children Mental Health Clinic/Center
  • Orlando, FL
  • NPI 1114426400
  NPD (past) Authorized official

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

{
    "created_epoch": "1281484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491868800000",
    "number": "1568777811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1743 GAY DR",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328031914",
            "telephone_number": "407-716-7669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1743 GAY DR",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328031914",
            "telephone_number": "407-716-7669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLER",
        "first_name": "MICHAEL",
        "middle_name": "EUGENE",
        "credential": "MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-08-11",
        "last_updated": "2017-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "IMH 5580",
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Full of Grace Behavioral Healthcare
• Fuller & Associates, LLC
• Anna Maria Fuller, RN
• Barbara B Fuller, LCSW
• Margaret Fuller
• Sabrina Misty Fuller
• Veronica Fuller
• Brenna Sullivan Fullerton, M.D.
• Shannia Fullerton
• Fullness of Life ABA Services LLC

• Behavior Technician in Orlando, FL
• Providers in Orlando, FL by specialty
• Behavior Technician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2017; 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.