Pamela Fullerton, M.A., M.ED., LCPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Practice address

7132 N Harlem Ave Ste 102
Chicago, IL 60631-1086

Phone

(847) 701-4533

NPI assigned

Sep 16, 2021

Last updated

Apr 6, 2023By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in IL

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

Specialty

Mental Health Counselor

Education

Other, 2018

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts, Master of Education

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Advocacy & Education Consulting PLLC

  • Mental Health Counselor
  • Chicago, IL
  • NPI 1659048858

  Professional

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1631750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680739200000",
    "number": "1881364206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7132 N HARLEM AVE STE 102",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606311086",
            "telephone_number": "847-701-4533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7132 N HARLEM AVE STE 102",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606311086",
            "telephone_number": "847-701-4533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLERTON",
        "first_name": "PAMELA",
        "credential": "M.A., M.ED., LCPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-09-16",
        "last_updated": "2023-04-06",
        "certification_date": "2023-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Fullerton Skilled Nursing Facility LLC (Avantara Lincoln Park)
• Fullerton Skilled Nursing Facility LLC (Avantara Lincoln Park)
• Fullerton Skilled Nursing Facility LLC (Avantara Lincoln Park)
• Fullerton Surgery Center LTD
• Fullerton Vision LLC
• Constance Anita Fullilove, PH.D.
• Rodney M Fullmer, D.O.
• Fullsmile Family Dentist
• Judy Ann Fulop, ND
• Fulton Market MRI LLC

• Professional Counselor in Chicago, IL
• Providers in Chicago, IL by specialty
• Professional Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2023; 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.