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CHARIDITH FULLER MS
NPI 1144981887
Marriage & Family Therapist in Cleveland, TN

Active since January 05, 2022Opted out of Medicare · through Jul 24, 2028
391 BROAD ST. SW, STE 202, CLEVELAND, TN 37311(423) 641-1105 Get Directions Write a Review

NPPES record last updated: January 5, 2022. Verified against the NPPES registry weekly; last sync: September 27, 2026.

About Charidith Fuller Ms NPPES

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

CHARIDITH FULLER MS (NPI 1144981887) is an individual marriage & family therapist in Cleveland, Tennessee, licensed in Tennessee (1936) and active in the NPI registry since January 2022. She has opted out of Medicare through July 24, 2028.

NPPES Registry Identity

NPI1144981887
Entity TypeIndividualFemale
Primary Taxonomy106H00000X
Provider Legal NameCHARIDITH FULLERCredential: MS
Location Address391 BROAD ST. SW, STE 202Cleveland, TN 37311
Mailing Address2708 Bryant Dr SwCleveland, TN 37311-0824 · (810) 623-5450
Phone(423) 641-1105
Sole ProprietorNo
Enumeration DateJanuary 5, 2022
NPPES CertifiedJanuary 4, 2022
✔ NPI 1144981887 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyMarriage & Family TherapistBehavioral Health & Social Service Providers
Taxonomy Code106H00000X
License✔ Licensed in TN · 1936
Definition
A marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives supervised clinical experience, or a person who meets the state requirements to practice as a marriage and family therapist. A marriage and family therapist treats mental and emotional disorders within the context of marriage and family systems. A marriage and family therapist provides mental health and counseling services to individuals, couples, families, and groups.
391 BROAD ST. SW, Cleveland, TN 37311
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Charidith Fuller Ms has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from July 24, 2024 through July 24, 2028.

Opt-Out Effective DateJuly 24, 2024
Opt-Out In Effect ThroughJuly 24, 2028Opt-out affidavits renew automatically every two years unless cancelled

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 Charidith Fuller's NPI number?

The NPI number for Charidith Fuller is 1144981887. It was assigned to this individual provider in the NPPES registry on January 5, 2022.

Where is Charidith Fuller located?

Charidith Fuller practices at 391 Broad St. SW Ste 202, Cleveland, TN 37311. The listed phone number is (423) 641-1105.

What is Charidith Fuller's specialty?

The primary specialty registered for this NPI is Marriage & Family Therapist with taxonomy code 106H00000X.

Is Charidith Fuller enrolled in Medicare?

No. Charidith Fuller has opted out of Medicare through July 24, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

When was this NPI record last updated?

The NPPES record for Charidith Fuller was last updated on January 5, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.