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SHANE R FULLERTON
NPI 1063862852
Counselor in Kailua Kona, HI

Active since June 13, 2016
75-5699 ALII DR STE E, KAILUA KONA, HI 96740(443) 226-4939 Get Directions Write a Review

NPPES record last updated: June 14, 2016. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Shane R Fullerton NPPES

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

SHANE R FULLERTON (NPI 1063862852) is an individual counselor in Kailua Kona, Hawaii and active in the NPI registry since June 2016.

NPPES Registry Identity

NPI1063862852
Entity TypeIndividualMale
Primary Taxonomy101Y00000X
Provider Legal NameSHANE R FULLERTON
Location Address75-5699 ALII DR STE EKailua Kona, HI 96740-3112
Mailing Address75-5699 Alii Dr Ste EKailua Kona, HI 96740-3112
Phone(443) 226-4939
Sole ProprietorNo
Enumeration DateJune 13, 2016
Last NPPES UpdateJune 14, 2016
✔ NPI 1063862852 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselorBehavioral Health & Social Service Providers
Taxonomy Code101Y00000X
Definition
A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.
75-5699 ALII DR STE E, Kailua Kona, HI 96740
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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 Shane Fullerton's NPI number?

The NPI number for Shane Fullerton is 1063862852. It was assigned to this individual provider in the NPPES registry on June 13, 2016.

Where is Shane Fullerton located?

Shane Fullerton practices at 75-5699 Alii Dr Ste E, Kailua Kona, HI 96740. The listed phone number is (443) 226-4939.

What is Shane Fullerton's specialty?

The primary specialty registered for this NPI is Counselor with taxonomy code 101Y00000X.

When was this NPI record last updated?

The NPPES record for Shane Fullerton was last updated on June 14, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.