PHOENIX FULLENWIDER
NPI 1417817875
Marriage & Family Therapist in Ocoee, FL

Q: What is Phoenix Fullenwider's NPI number?

The NPI number for Phoenix Fullenwider is 1417817875. It was assigned to this individual provider in the NPPES registry on November 17, 2025.

Q: What is Phoenix Fullenwider's specialty?

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

Active since November 17, 2025

630 FORTANINI CIR, OCOEE, FL 34761(321) 464-9672 Get Directions Write a Review

NPPES record last updated: November 17, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Phoenix Fullenwider NPPES

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

PHOENIX FULLENWIDER (NPI 1417817875) is an individual marriage & family therapist in Ocoee, Florida and active in the NPI registry since November 2025.

NPPES Registry Identity

NPI1417817875

Entity TypeIndividualFemale

Primary Taxonomy106H00000X

Provider Legal NamePHOENIX FULLENWIDER

Location Address630 FORTANINI CIROcoee, FL 34761-5077

Mailing Address630 Fortanini CirOcoee, FL 34761-5077 · (321) 464-9672

Phone(321) 464-9672

Sole ProprietorYes

Enumeration DateNovember 17, 2025

NPPES CertifiedNovember 17, 2025

✔ NPI 1417817875 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyMarriage & Family TherapistBehavioral Health & Social Service Providers

Taxonomy Code106H00000X

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.

630 FORTANINI CIR, Ocoee, FL 34761

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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 Phoenix Fullenwider's NPI number?

The NPI number for Phoenix Fullenwider is 1417817875. It was assigned to this individual provider in the NPPES registry on November 17, 2025.

Where is Phoenix Fullenwider located?

Phoenix Fullenwider practices at 630 Fortanini Cir, Ocoee, FL 34761. The listed phone number is (321) 464-9672.

What is Phoenix Fullenwider's specialty?

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

When was this NPI record last updated?

The NPPES record for Phoenix Fullenwider was last updated on November 17, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 months 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.