Active NPI
Jennifer Fuller, LPC, LAC, AADC, NCC
- Professional Counselor
- Arkadelphia, AR
National Provider Identifier
1801386230
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 6149
- Practice address
- 615 Crittenden St Unit 243
Arkadelphia, AR 71923-7787 - Phone
- (870) 260-9106
- NPI assigned
- May 10, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 6149 | LA | Primary |
| Professional Counselor | 101YP2500X | 2018009719 | MO | |
| Professional Counselor | 101YP2500X | 012455 | GA |
Addresses
Primary practice location
615 Crittenden St Unit 243
Arkadelphia, AR 71923-7787
Mailing address
615 Crittenden St Unit 243
Arkadelphia, AR 71923-7787
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 |
|---|---|---|---|
| 012455 | GA | MD | Professional Counselor |
| 6149 | LA | MD | Professional Counselor |
| 2018009719 | MO | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1525910400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1764547200000",
"number": "1801386230",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "615 CRITTENDEN ST UNIT 243",
"city": "ARKADELPHIA",
"state": "AR",
"postal_code": "719237787"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "615 CRITTENDEN ST UNIT 243",
"city": "ARKADELPHIA",
"state": "AR",
"postal_code": "719237787",
"telephone_number": "870-260-9106"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FULLER",
"first_name": "JENNIFER",
"credential": "LPC, LAC, AADC, NCC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-05-10",
"last_updated": "2025-12-01",
"certification_date": "2025-12-01",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "LA",
"license": "6149",
"primary": true
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MO",
"license": "2018009719",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "GA",
"license": "012455",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Arkadelphia, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 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.