Keila Fulkerson, LPCC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

269359 Issued in KY

Practice address

104 S Front Ave
Prestonsburg, KY 41653-1614

Phone

(606) 886-8572

Fax

(606) 886-4433

NPI assigned

Feb 15, 2017

Sex

Female

Sole proprietor

No

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 KY

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, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Kentucky Counseling Center LLCGroup PAC ID 7618221300, 57 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Kentucky Counseling Center, LLC

  • Counselor
  • Louisville, KY
  • NPI 1932590338
  Medicare reassignment Care Compare group NPD
• Mountain Comprehensive Care Center, Inc.

  • Mental Health Counselor
  • Prestonsburg, KY
  • NPI 1760491674
  Medicare reassignment NPD
• Mountain Comprehensive Care Center, Inc.

  dba Homeplace Clinic Prestonsburg

  • Federally Qualified Health Center (FQHC)
  • Prestonsburg, KY
  • NPI 1336989292
  NPD
• Mountain Comprehensive Care Center, Inc.

  dba Homeplace Clinic Mobile Unit

  • Federally Qualified Health Center (FQHC)
  • Paintsville, KY
  • NPI 1699386078
  NPD

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

{
    "created_epoch": "1487116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616630400000",
    "number": "1912446535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 S FRONT AVE",
            "city": "PRESTONSBURG",
            "state": "KY",
            "postal_code": "416531614",
            "telephone_number": "606-886-8572",
            "fax_number": "606-886-4433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 S FRONT AVE",
            "city": "PRESTONSBURG",
            "state": "KY",
            "postal_code": "416531614",
            "telephone_number": "606-886-8572",
            "fax_number": "606-886-4433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULKERSON",
        "first_name": "KEILA",
        "credential": "LPCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-02-15",
        "last_updated": "2021-03-25",
        "certification_date": "2021-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "KY",
            "license": "269359",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Isabella Fugate
• Kenneth Fugate, PERSP
• Lucinda Fugate
• Teresa Fugate
• Tonia Fugate
• Karen Fuller
• Blake Fultz
• John Rowe Furcolow, M.D.
• Shannon D Fyffe, APRN
• Stephany Fyffe

• Professional Counselor in Prestonsburg, KY
• Providers in Prestonsburg, KY by specialty
• Professional Counselor in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2021; 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.