Kelly Sue Fuller, L.P.C.

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

0701003292 Issued in VA

Practice address

1545 Crossways Blvd Ste 250
Chesapeake, VA 23320-0218

Phone

(757) 419-1726

NPI assigned

Apr 3, 2007

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1175558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713744000000",
    "number": "1871614115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 FLAX MILL WAY",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233225893",
            "telephone_number": "757-419-1726",
            "fax_number": "757-419-1726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1545 CROSSWAYS BLVD STE 250",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233200218",
            "telephone_number": "757-419-1726"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLER",
        "first_name": "KELLY",
        "middle_name": "SUE",
        "name_prefix": "Mrs.",
        "credential": "L.P.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-03",
        "last_updated": "2024-04-22",
        "certification_date": "2024-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NC",
            "license": "4184",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "VA",
            "license": "0701003292",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brett Frommer, DO
• Kenneth Frumkin, M.D.
• Lori-Ann Fuehrer
• Carson Fuhrman, PSY.D.
• Greg Richardson Fuller, DO
• Kim Kevin Fuller, D.C.
• Kimberly M Fuller, NP
• Nashai Funches
• Melinda Debra Dowe Furstman, RNFA, BA, CNOR
• Christopher Fusco, OD

• Professional Counselor in Chesapeake, VA
• Providers in Chesapeake, VA by specialty
• Professional Counselor in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.