Active NPI
FFC PLLC
- Professional Counselor
- Southfield, MI
National Provider Identifier
1821808296
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- Legal business name
- FFC PLLC
- Practice address
- 29532 Southfield Rd Ste 115
Southfield, MI 48076-2023 - Phone
- (734) 215-5404
- Fax
- (570) 989-5073
- NPI assigned
- Jan 8, 2025
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Jake Edward Fuller, LPC
- Title
- Managing Member
- Phone
- (312) 718-4221
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | Primary |
Addresses
Primary practice location
29532 Southfield Rd Ste 115
Southfield, MI 48076-2023
Mailing address
29532 Southfield Rd Ste 115
Southfield, MI 48076-2023
Phone (734) 215-5404
Other practice location 1
112 W Shawnee St
Tecumseh, MI 49286-1566
Phone (312) 718-4221
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
Enrollment records 1
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1736294400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1778112000000",
"number": "1821808296",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "29532 SOUTHFIELD RD STE 115",
"city": "SOUTHFIELD",
"state": "MI",
"postal_code": "480762023",
"telephone_number": "734-215-5404",
"fax_number": "570-989-5073"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "29532 SOUTHFIELD RD STE 115",
"city": "SOUTHFIELD",
"state": "MI",
"postal_code": "480762023",
"telephone_number": "734-215-5404",
"fax_number": "570-989-5073"
}
],
"practiceLocations": [
{
"address_1": "112 W Shawnee St",
"address_purpose": "LOCATION",
"city": "Tecumseh",
"state": "MI",
"postal_code": "492861566",
"country_code": "US",
"telephone_number": "312-718-4221",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"organization_name": "FFC PLLC",
"organizational_subpart": "NO",
"enumeration_date": "2025-01-08",
"last_updated": "2026-05-07",
"certification_date": "2026-05-07",
"status": "A",
"authorized_official_last_name": "FULLER",
"authorized_official_first_name": "JAKE",
"authorized_official_middle_name": "EDWARD",
"authorized_official_title_or_position": "MANAGING MEMBER",
"authorized_official_telephone_number": "312-718-4221",
"authorized_official_name_prefix": "Mr.",
"authorized_official_credential": "LPC"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Counselor, Professional",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Southfield, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.