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KENNETH FULTZ CPRM
NPI 1023574787
Peer Specialist in Detroit, MI

Active since February 18, 2019
15941 FAIRFIELD ST, DETROIT, MI 48238(313) 345-4310(313) 345-4315 Get Directions Write a Review

NPPES record last updated: February 18, 2019. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Kenneth Fultz Cprm NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KENNETH FULTZ CPRM (NPI 1023574787) is an individual peer specialist in Detroit, Michigan and active in the NPI registry since February 2019.

NPPES Registry Identity

NPI1023574787
Entity TypeIndividualMale
Primary Taxonomy175T00000X
Provider Legal NameKENNETH FULTZCredential: CPRM
Location Address15941 FAIRFIELD STDetroit, MI 48238-4123
Mailing Address15941 Fairfield StDetroit, MI 48238-4123 · (313) 345-4310 · Fax (313) 345-4315
Phone(313) 345-4310
Fax(313) 345-4315
Sole ProprietorNo
Enumeration DateFebruary 18, 2019
✔ NPI 1023574787 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPeer SpecialistOther Service Providers
Taxonomy Code175T00000X
Definition
Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.
15941 FAIRFIELD ST, Detroit, MI 48238
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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MEGAN E DOYLE
Peer Specialist
15941 FAIRFIELD ST
DETROIT, MI 48238
Wayne County (313) 345-4310
IDELLMAR BYAIS BSW
Counselor (Addiction (Substance Use Disorder))
15941 FAIRFIELD ST
DETROIT, MI 48238
Wayne County (313) 345-4310
MS. RACHEL MARION SMITH
Counselor (Addiction (Substance Use Disorder))
15941 FAIRFIELD ST
DETROIT, MI 48238
Wayne County (313) 345-4310
ERIC CARTER
Peer Specialist
15941 FAIRFIELD ST
DETROIT, MI 48238
Wayne County (313) 345-4310
JONATHON EDWARD WILLIAMS BSW
Counselor (Addiction (Substance Use Disorder))
15941 FAIRFIELD ST
DETROIT, MI 48238
Wayne County (313) 345-4310
JUANITA CHARLESTON
Contractor
15941 FAIRFIELD ST
DETROIT, MI 48238
Wayne County (313) 855-6035
LAKERIDGE VILLAGE, INC.
Substance Abuse Rehabilitation Facility
15941 FAIRFIELD ST
DETROIT, MI 48238
Wayne County (313) 345-4310
GINA SMITH CPRM
Peer Specialist
15941 FAIRFIELD ST
DETROIT, MI 48238
Wayne County (313) 345-4310

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kenneth Fultz's NPI number?

The NPI number for Kenneth Fultz is 1023574787. It was assigned to this individual provider in the NPPES registry on February 18, 2019.

Where is Kenneth Fultz located?

Kenneth Fultz practices at 15941 Fairfield St, Detroit, MI 48238. The listed phone number is (313) 345-4310.

What is Kenneth Fultz's specialty?

The primary specialty registered for this NPI is Peer Specialist with taxonomy code 175T00000X.

When was this NPI record last updated?

The NPPES record for Kenneth Fultz was last updated on February 18, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.