Charles Robert Fuller II, LPC-S

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

72142 Issued in TX

Practice address

511 University Dr E Ste 210
College Station, TX 77840-1748

Phone

(979) 777-5545

NPI assigned

Dec 6, 2016

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Robbie Fuller Other name

Medicare fee-for-service enrollment

Enrolled in TX

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, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

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

• Fuller Counseling and Consulting, PLLC

  • Professional Counselor
  • College Station, TX
  • NPI 1518647627
  Medicare reassignment NPD Authorized official
• Miracle Farm, Inc.

  • Voluntary or Charitable Agency
  • Brenham, TX
  • NPI 1679091789
  NPD (past)

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

{
    "created_epoch": "1480982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785369600000",
    "number": "1952845240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "511 UNIVERSITY DR E STE 210",
            "city": "COLLEGE STATION",
            "state": "TX",
            "postal_code": "778401748",
            "telephone_number": "979-777-5545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "511 UNIVERSITY DR E STE 210",
            "city": "COLLEGE STATION",
            "state": "TX",
            "postal_code": "778401748",
            "telephone_number": "979-777-5545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLER",
        "first_name": "CHARLES",
        "middle_name": "ROBERT",
        "name_prefix": "Mr.",
        "name_suffix": "II",
        "credential": "LPC-S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-12-06",
        "last_updated": "2026-07-30",
        "certification_date": "2026-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TX",
            "license": "72142",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "72142",
            "primary": true
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "TX",
            "license": "72142",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ROBBIE",
            "last_name": "FULLER",
            "credential": "LPC-S",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Micah Frey
• Hanna Marie Friddle, MSN, APRN, FNP-C
• Denzil Kenneth Frost, D.O.
• Fulfilled Journey Counseling, PLLC
• Fuller Counseling and Consulting, PLLC
• Karla Faye Gaar
• Jolie Marie Gade, CCC-SLP
• Maikel Gadelsayed
• Nancy Gadelsayed, PHARMD
• William Gerald Gaines Jr., MD

• Professional Counselor in College Station, TX
• Providers in College Station, TX by specialty
• Professional Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2026; 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.