Organization Active NPI

FFC PLLC

  • Professional Counselor
  • Southfield, MI
National Provider Identifier
1821808296
Registry record updated May 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
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

Updated by the provider on May 7, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Jake Edward Fuller, LPCNPI 1477313815
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)CodeLicenseStatePrimary
Professional CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 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

Enrollment IDStateProvider typePAC IDDetails
O20260625003669 MI Part B Supplier - Clinic/Group Practice 3577036060 Receives reassigned benefits from 1 practitioner
Practice locations: Southfield, MI

National Provider Directory

National Provider Directory

Practitioners & 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.

Verify at the official NPI Registry.