Lori Allison Fultz, LCPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LC11397 Issued in MD

Practice address

16701 Melford Blvd Ste 400
Bowie, MD 20715-4411

Phone

(415) 424-4266

Fax

(415) 520-6633

NPI assigned

Mar 18, 2021

Sex

Female

Sole proprietor

No

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": "1616025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681862400000",
    "number": "1730765041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16701 MELFORD BLVD STE 400",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207154411",
            "telephone_number": "415-424-4266",
            "fax_number": "415-520-6633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16701 MELFORD BLVD STE 400",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207154411",
            "telephone_number": "415-424-4266",
            "fax_number": "415-520-6633"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9627 Philadelphia Rd Ste 160",
            "address_purpose": "LOCATION",
            "city": "Rosedale",
            "state": "MD",
            "postal_code": "212374157",
            "country_code": "US",
            "telephone_number": "410-780-5203 x500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FULTZ",
        "first_name": "LORI",
        "middle_name": "ALLISON",
        "credential": "LCPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-18",
        "last_updated": "2023-04-19",
        "certification_date": "2023-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MD",
            "license": "LC11397",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Professional Counselor in Bowie, MD
• Providers in Bowie, MD by specialty
• Professional Counselor in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2023; 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.