Kondra Mia Fulmer

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

0701006170 Issued in VA

Practice address

4850 Mark Center Dr
Alexandria, VA 22311-1882

Phone

(703) 746-3400

NPI assigned

Jul 8, 2006

Sex

Female

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

Enrolled in DC, MD2 enrollments

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 2

Specialty

Mental Health Counselor

Education

Other, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Safe Harbor Behavioral Care LLCGroup PAC ID 0345514675, 81 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

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 and National Provider Directory roles.

• Safe Harbor Behavioral Care, LLC

  • Clinical Social Worker
  • Bel Air, MD
  • NPI 1316487879

  Mental Health

  Medicare reassignment Care Compare group NPD
• City of Alexandria

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Alexandria, VA
  • NPI 1447279658

  DC

  Medicare reassignment NPD
• Kondra Fulmer Counseling, LLC

  • Adult Mental Health Clinic/Center
  • Clinton, MD
  • NPI 1720795958
  NPD Authorized official
• City of Alexandria

  • Ambulance
  • Alexandria, VA
  • NPI 1902970593
  NPD

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

{
    "created_epoch": "1152316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718841600000",
    "number": "1659304384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "975 N SELOMONS ISLAND",
            "address_2": "PO BOX 980",
            "city": "PRINCE FREDERICK",
            "state": "MD",
            "postal_code": "20678",
            "telephone_number": "410-535-5400",
            "fax_number": "410-414-9413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4850 MARK CENTER DR",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223111882",
            "telephone_number": "703-746-3400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "975 N Selomons Island",
            "address_purpose": "LOCATION",
            "city": "Prince Frederick",
            "state": "MD",
            "postal_code": "20678",
            "country_code": "US",
            "telephone_number": "410-535-5400 x475",
            "fax_number": "410-414-9413",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FULMER",
        "first_name": "KONDRA",
        "middle_name": "MIA",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-08",
        "last_updated": "2024-06-20",
        "certification_date": "2024-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MD",
            "license": "LC2175",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "VA",
            "license": "0701006170",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Fueled & Fed Nutrition
• Ana S Fuentes, MD
• Full Circle Mental Health Services
• Kathleen Fuller, FNP-BC
• Yasmeen Fuller, MA, LRC-LPC
• Alexus Mai Fulton
• Jeffrey Fulton
• Florence P Fungwe
• Lauren Furtner
• Ellen Christine Fye, M.A., CCC-SLP

• Professional Counselor in Alexandria, VA
• Providers in Alexandria, VA by specialty
• Professional Counselor in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2024; 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.