Active NPI
Quincy Fuller
- Counselor
- Kenai, AK
National Provider Identifier
1699455253
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- Practice address
- 508 Upland St
Kenai, AK 99611-8026 - Phone
- (907) 953-3491
- NPI assigned
- Jul 19, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | AK | ||
| Counselor | 101Y00000X | AK | Primary |
Addresses
Primary practice location
508 Upland St
Kenai, AK 99611-8026
Mailing address
508 Upland St
Kenai, AK 99611-8026
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1689724800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1750291200000",
"number": "1699455253",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "508 UPLAND ST",
"city": "KENAI",
"state": "AK",
"postal_code": "996118026"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "508 UPLAND ST",
"city": "KENAI",
"state": "AK",
"postal_code": "996118026",
"telephone_number": "907-953-3491"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FULLER",
"first_name": "QUINCY",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-07-19",
"last_updated": "2025-06-19",
"certification_date": "2025-06-19",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "AK",
"license": null,
"primary": false
},
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "AK",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kenai, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 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.