Active NPI
Stephen Keith Fuller, LPC
- Professional Counselor
- Plainwell, MI
National Provider Identifier
1790107720
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 6401008583
- Practice address
- 319 Park St
Plainwell, MI 49080-1655 - Phone
- (269) 685-9401
- Fax
- (269) 685-9403
- NPI assigned
- Jan 10, 2014
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 6401008583 | MI | Primary |
Addresses
Primary practice location
319 Park St
Plainwell, MI 49080-1655
Mailing address
319 Park St
Plainwell, MI 49080-1655
Phone (269) 685-9401
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6401008583 | MI | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1389312000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1389312000000",
"number": "1790107720",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "319 PARK ST",
"city": "PLAINWELL",
"state": "MI",
"postal_code": "490801655",
"telephone_number": "269-685-9401",
"fax_number": "269-685-9403"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "319 PARK ST",
"city": "PLAINWELL",
"state": "MI",
"postal_code": "490801655",
"telephone_number": "269-685-9401",
"fax_number": "269-685-9403"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FULLER",
"first_name": "STEPHEN",
"middle_name": "KEITH",
"credential": "LPC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-01-10",
"last_updated": "2014-01-10",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MI",
"license": "6401008583",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Plainwell, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.