Active NPI
Dana Marie Fuller, MA, LPC
- Professional Counselor
- Pontiac, MI
National Provider Identifier
1952739799
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 6401008611
- Practice address
- 691 Orchard Lake Rd
Pontiac, MI 48341-2039 - Phone
- (248) 874-1282
- NPI assigned
- Oct 14, 2013
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 6401008611 | MI | Primary |
Addresses
Primary practice location
691 Orchard Lake Rd
Pontiac, MI 48341-2039
Mailing address
691 Orchard Lake Rd
Pontiac, MI 48341
Phone (248) 874-1282
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6401008611 | MI | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1381708800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1381708800000",
"number": "1952739799",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "691 ORCHARD LAKE RD",
"city": "PONTIAC",
"state": "MI",
"postal_code": "48341",
"telephone_number": "248-874-1282"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "691 ORCHARD LAKE RD",
"city": "PONTIAC",
"state": "MI",
"postal_code": "483412039",
"telephone_number": "248-874-1282"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FULLER",
"first_name": "DANA",
"middle_name": "MARIE",
"name_prefix": "Ms.",
"credential": "MA, LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-10-14",
"last_updated": "2013-10-14",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MI",
"license": "6401008611",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pontiac, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.