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MR. JEFFREY RAY FULKERSON M ED, MS, LAC, LPC
NPI 1417457623
Counselor - Professional in Tempe, AZ

Active since February 14, 2018PECOS EnrolledAccepts Medicare Assignment
3920 S RURAL RD STE 112, TEMPE, AZ 85282(480) 428-2944(480) 680-5361 Get Directions Write a Review

NPPES record last updated: December 22, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Mr. Jeffrey Ray Fulkerson M Ed, Ms, Lac, Lpc NPPES

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

MR. JEFFREY RAY FULKERSON M ED, MS, LAC, LPC (NPI 1417457623) is an individual professional provider in Tempe, Arizona, licensed in Arizona (LPC-21211) and active in the NPI registry since February 2018. He is enrolled in Medicare PECOS and is a graduate of Other (2017).

NPPES Registry Identity

NPI1417457623
Entity TypeIndividualMale
Primary Taxonomy101YP2500X
Provider Legal NameMR. JEFFREY RAY FULKERSONCredential: M ED, MS, LAC, LPC
Location Address3920 S RURAL RD STE 112Tempe, AZ 85282-5500
Mailing Address3920 S Rural Rd Ste 112Tempe, AZ 85282-5500 · (480) 428-2944 · Fax (480) 680-5361
Phone(480) 428-2944
Fax(480) 680-5361
Sole ProprietorNo
Medical School CMSOtherGraduated 2017
Enumeration DateFebruary 14, 2018
Last NPPES UpdateDecember 22, 2023
NPPES CertifiedDecember 22, 2023
✔ NPI 1417457623 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers
Taxonomy Code101YP2500X
License✔ Licensed in AZ · LPC-21211
3920 S RURAL RD STE 112, Tempe, AZ 85282
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross Blue Shield of Arizona, Oscar Health Plan, Inc., UnitedHealthcare and more.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Mr. Jeffrey Ray Fulkerson M Ed, Ms, Lac, Lpc is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID8820440621
PECOS Enrollment IDI20240117002594
Eligible to Order & Refer– Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 16

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

DEBORAH KOVALESKI MA, LPC
Counselor (Professional)
3920 S RURAL RD STE 112
TEMPE, AZ 85282
Maricopa County (480) 428-2944
AJ SOUTHWEST VENTURES INC
Marriage & Family Therapist
3920 S RURAL RD STE 112
TEMPE, AZ 85282
Maricopa County (480) 674-9220
MRS. AMBER DANCE LAC
Counselor (Mental Health)
3920 S RURAL RD STE 112
TEMPE, AZ 85282
Maricopa County (480) 428-2944
MICHELLE REIJONEN PMHNP
Nurse Practitioner (Psychiatric/Mental Health)
3920 S RURAL RD STE 112
TEMPE, AZ 85282
Maricopa County (480) 674-9220
ABBY BAILLY MSW, LCSW
Social Worker (Clinical)
3920 S RURAL RD STE 112
TEMPE, AZ 85282
Maricopa County (480) 808-3672
MR. PAUL K. GIBSON MC, LMFT
Marriage & Family Therapist
3920 S RURAL RD STE 112
TEMPE, AZ 85282
Maricopa County (480) 428-2944
MICHAEL SHUMWAY LAC
Counselor
3920 S RURAL RD STE 112
TEMPE, AZ 85282
Maricopa County (480) 428-2944
ASHLEY FRANCHETTO LPC
Counselor (Professional)
3920 S RURAL RD STE 112
TEMPE, AZ 85282
Maricopa County (480) 428-2944

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 Jeffrey Fulkerson's NPI number?

The NPI number for Jeffrey Fulkerson is 1417457623. It was assigned to this individual provider in the NPPES registry on February 14, 2018.

Where is Jeffrey Fulkerson located?

Jeffrey Fulkerson practices at 3920 S Rural Rd Ste 112, Tempe, AZ 85282. The listed phone number is (480) 428-2944.

What is Jeffrey Fulkerson's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

Is Jeffrey Fulkerson enrolled in Medicare?

Yes. Jeffrey Fulkerson is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Jeffrey Fulkerson accept?

Health plans from Blue Cross Blue Shield of Arizona, Oscar Health Plan, Inc., UnitedHealthcare and University of Utah Health Plans list Jeffrey Fulkerson as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Jeffrey Fulkerson was last updated on December 22, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.