Jennifer D Fuller, L.P.C., C.A.C. II

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

5780 Issued in CO

Practice address

304 W Baseline Rd
Lafayette, CO 80026-1719

Phone

(303) 827-4973

NPI assigned

May 12, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CO, WA, ID3 enrollments

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 3

Specialty

Mental Health Counselor

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Talkspace Provider Network Co, PC 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Talkspace Provider Network Co, PC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • New York, NY
  • NPI 1518747385

  CO

  Medicare reassignment Care Compare group NPD
• Talkspace Provider Network PA

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • New York, NY
  • NPI 1639814049

  ID

  Medicare reassignment NPD
• Talkspace Wa Psychiatry PC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • New York, NY
  • NPI 1508629494

  WA

  Medicare reassignment NPD
• Resilient Life Counseling Services, PLLC

  • Professional Counselor
  • Colorado Springs, CO
  • NPI 1497460901
  NPD (past)

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

{
    "created_epoch": "1305158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473897600000",
    "number": "1861784571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1109 STEIN ST",
            "city": "LAFAYETTE",
            "state": "CO",
            "postal_code": "800261850",
            "telephone_number": "303-827-4973"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "304 W BASELINE RD",
            "city": "LAFAYETTE",
            "state": "CO",
            "postal_code": "800261719",
            "telephone_number": "303-827-4973"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLER",
        "first_name": "JENNIFER",
        "middle_name": "D",
        "name_prefix": "Ms.",
        "credential": "L.P.C., C.A.C. II",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-05-12",
        "last_updated": "2016-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CO",
            "license": "7203",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CO",
            "license": "5780",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Froc, PC
• Teresa Regine Froelich, RD
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• Angela Kay Fryer, MD
• Andrea Torres Fujimoto
• Collene Fulton, ELECTROLOGIST
• Karen Anne Funk, MD
• Kayla Furbish
• Nicole Gacnik, PHARMD
• Michelle Gaffaney

• All providers in Lafayette, CO
• Mental Health Counselor in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2016; 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.