Marcie Susan Fuller, LPCC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

02340 Issued in MN

Practice address

6701 Parkway Cir Ste 300
Brooklyn Center, MN 55430-2849

Phone

(612) 767-7222

NPI assigned

Feb 2, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Marcie Susan Gilligan Former name

Medicare fee-for-service enrollment

Enrolled in MN

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

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.

• Fraser Child and Family Center

  • Adolescent and Children Mental Health Clinic/Center
  • Minneapolis, MN
  • NPI 1609922194
  Medicare reassignment NPD

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

{
    "created_epoch": "1612224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760659200000",
    "number": "1871184739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1161 BAY RD",
            "city": "MADISON",
            "state": "SD",
            "postal_code": "570426763",
            "telephone_number": "605-777-4619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6701 PARKWAY CIR STE 300",
            "city": "BROOKLYN CENTER",
            "state": "MN",
            "postal_code": "554302849",
            "telephone_number": "612-767-7222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLER",
        "first_name": "MARCIE",
        "middle_name": "SUSAN",
        "credential": "LPCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-02-02",
        "last_updated": "2025-10-17",
        "certification_date": "2025-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MN",
            "license": "02340",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARCIE",
            "last_name": "GILLIGAN",
            "middle_name": "SUSAN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Richard Freese
• Emily Catherine Freundschuh, MS, LMFT
• Claire Ann Friedman
• Trent Frisch, D.C.
• Fulfilledlyf Care and Community Services LLC
• Lanajia Marie Gail
• Anne Louise Gair, MD
• Jane Galvez-Gonzalez
• Stephanie Garcia, LMFT
• Aviauna Gardner

• Mental Health Counselor in Brooklyn Center, MN
• Providers in Brooklyn Center, MN by specialty
• Mental Health Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2025; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.