Nicholas M Fuller, LMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

8320 Madison Ave
Indianapolis, IN 46227-6066

Phone

(317) 882-5122

Fax

(317) 888-8642

NPI assigned

Aug 18, 2017

Sex

Male

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

Enrolled in IN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Concordia Counseling a Lutheran Outreach Ministry IncGroup PAC ID 7810426277, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Concordia Counseling: a Lutheran Outreach Ministry, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Seymour, IN
  • NPI 1568150068
  Medicare reassignment Care Compare group NPD
• Adult and Child Mental Health Center Inc

  • Community/Behavioral Health Agency
  • Indianapolis, IN
  • NPI 1154368512

  Mental Health

  Medicare reassignment NPD
• Adult and Child Mental Health Center Inc

  • Community/Behavioral Health Agency
  • Indianapolis, IN
  • NPI 1083432272
  NPD

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

{
    "created_epoch": "1503014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1811413149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8320 MADISON AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462276066",
            "telephone_number": "317-882-5122",
            "fax_number": "317-888-8642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8320 MADISON AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462276066",
            "telephone_number": "317-882-5122",
            "fax_number": "317-888-8642"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLER",
        "first_name": "NICHOLAS",
        "middle_name": "M",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-08-18",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Full Embrace Medical Equipment & Supplies LLC
• Abigail Fuller, RBT
• Adasia Fuller
• Elizabeth J. Fuller, MSN, RN, CNS
• Jeff Fuller, MSW, LSW
• Ryan Michael Fuller, R.PH
• Samuel Thomas Fuller
• Tammy Lynn Fuller, FNP
• Michelle Fulner
• Colette Fults, EDS, MS, LMHC

• Mental Health Counselor in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Mental Health Counselor in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.