MIKHAEL JAMES FULLER MA
NPI 1417551409
Marriage & Family Therapist in Vancouver, WA

Q: What is Mikhael Fuller's NPI number?

The NPI number for Mikhael Fuller is 1417551409. It was assigned to this individual provider in the NPPES registry on November 30, 2020.

Q: What is Mikhael Fuller's specialty?

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

Q: Is Mikhael Fuller enrolled in Medicare?

No. Mikhael Fuller has opted out of Medicare through February 27, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

Q: When was this NPI record last updated?

The NPPES record for Mikhael Fuller was last updated on June 4, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.

Active since November 30, 2020Opted out of Medicare · through Feb 27, 2028

3002 MAIN ST, VANCOUVER, WA 98663(925) 403-1737 Get Directions Write a Review

NPPES record last updated: June 4, 2021. Verified against the NPPES registry weekly; last sync: October 04, 2026.

Record update history: Jun 4, 2021, Nov 30, 2020 (2 updates tracked since 2020).

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About Mikhael James Fuller Ma NPPES

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

MIKHAEL JAMES FULLER MA (NPI 1417551409) is an individual marriage & family therapist in Vancouver, Washington, licensed in California (123166) and active in the NPI registry since November 2020. He has opted out of Medicare through February 27, 2028 and remains eligible to order and refer and maintains a secondary practice location in Lafayette.

NPPES Registry Identity

NPI1417551409

Entity TypeIndividualMale

Primary Taxonomy106H00000X

Provider Legal NameMIKHAEL JAMES FULLERCredential: MA

Location Address3002 MAIN STVancouver, WA 98663-2750

Mailing Address3002 Main StVancouver, WA 98663-2750

Phone(925) 403-1737

Sole ProprietorYes

Enumeration DateNovember 30, 2020

Last NPPES UpdateJune 4, 20212 updates tracked since enumeration

NPPES CertifiedJune 4, 2021

✔ NPI 1417551409 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 CA · 123166

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.

3002 MAIN ST, Vancouver, WA 98663

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Secondary Practice Location 1

Location 1954 Risa Rd Ste ALafayette, CA 94549-3418 · Phone (925) 403-1737

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Mikhael James Fuller Ma 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 February 27, 2024 through February 27, 2028.

Opt-Out Effective DateFebruary 27, 2024

Opt-Out In Effect ThroughFebruary 27, 2028Opt-out affidavits renew automatically every two years unless cancelled

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

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 Mikhael Fuller's NPI number?

The NPI number for Mikhael Fuller is 1417551409. It was assigned to this individual provider in the NPPES registry on November 30, 2020.

Where is Mikhael Fuller located?

Mikhael Fuller practices at 3002 Main St, Vancouver, WA 98663. The listed phone number is (925) 403-1737.

What is Mikhael Fuller's specialty?

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

Is Mikhael Fuller enrolled in Medicare?

No. Mikhael Fuller has opted out of Medicare through February 27, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

When was this NPI record last updated?

The NPPES record for Mikhael Fuller was last updated on June 4, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.