Natasha Lachine Fuller, MBA, QMHP-CS, PSS

Primary specialty

Peer SpecialistTaxonomy code 175T00000X

License

1376-0924 Issued in TX

Practice address

3008 Ross Ave Ste 100
Dallas, TX 75204-5519

Phone

(682) 277-9994

NPI assigned

Feb 26, 2024

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)

Enrolled

Credentials

Master of Business Administration

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.

• A Nation of Hope

  • Peer Specialist
  • Fort Worth, TX
  • NPI 1235995580
  NPD Authorized official

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

{
    "created_epoch": "1708905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744588800000",
    "number": "1720844939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5900 BALCONES DR STE 100",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787314298",
            "telephone_number": "682-277-9994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3008 ROSS AVE STE 100",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752045519",
            "telephone_number": "682-277-9994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLER",
        "first_name": "NATASHA",
        "middle_name": "LACHINE",
        "name_prefix": "Mrs.",
        "credential": "MBA, QMHP-CS, PSS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-02-26",
        "last_updated": "2025-04-14",
        "certification_date": "2025-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Peer Specialist",
            "state": "TX",
            "license": "1376-0924",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julie Marie Fuller, MD
• Kelcie Denea Fuller
• Lakeshia Rena Fuller, RN
• Lauren Caroline Fuller
• Michelle L Fuller, NPC
• Stephanie Renee Fuller, MS, FNP-C
• Timothy Fuller, MD
• Timothy Brandon Fuller, PRIMARY BENEFICIARY
• Fulllife Medical Supply
• Kylie Jeannine Fullner, DPT

• Peer Specialist in Dallas, TX
• Providers in Dallas, TX by specialty
• Peer Specialist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 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.