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MR. JAKE E FULLER LPC
NPI 1477313815
Counselor - Professional in Adrian, MI

Active since March 21, 2024PECOS Enrolled
142 E MAUMEE ST STE 3, ADRIAN, MI 49221(312) 718-4221 Get Directions Write a Review

NPPES record last updated: April 13, 2026. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Mr. Jake E Fuller Lpc NPPES

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

MR. JAKE E FULLER LPC (NPI 1477313815) is an individual professional provider in Adrian, Michigan, licensed in Michigan (6401226147) and active in the NPI registry since March 2024. He is enrolled in Medicare PECOS, maintains a secondary practice location in Tecumseh, and is a graduate of Other (2023).

NPPES Registry Identity

NPI1477313815
Entity TypeIndividualMale
Primary Taxonomy101YP2500X
Provider Legal NameMR. JAKE E FULLERCredential: LPC
Location Address142 E MAUMEE ST STE 3Adrian, MI 49221-2735
Mailing Address112 W Shawnee StTecumseh, MI 49286-1566 · (312) 718-4221
Phone(312) 718-4221
Sole ProprietorYes
Medical School CMSOtherGraduated 2023
Enumeration DateMarch 21, 2024
Last NPPES UpdateApril 13, 2026
NPPES CertifiedApril 13, 2026
✔ NPI 1477313815 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 MI · 6401226147
142 E MAUMEE ST STE 3, Adrian, MI 49221
Open in Google Maps ↗

Secondary Practice Location 1

Location 1112 W Shawnee StTecumseh, MI 49286-1566 · Phone (734) 215-5404

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health 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 (PECOS)

Mr. Jake E Fuller Lpc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID648746370
PECOS Enrollment IDI20260420001735
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 14

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

MRS. YASHICA MAXWELL LLMSW, LCSW, LICSW
Social Worker
142 E MAUMEE ST STE 3
ADRIAN, MI 49221
Lenawee County (517) 263-5810
LAURA JEANETTE PLUMMER
Counselor
142 E MAUMEE ST STE 3
ADRIAN, MI 49221
Lenawee County (517) 263-5810
KIMBERLY YODER, LLMSW PLLC
Clinic/Center (Mental Health (Including Community Mental Health Center))
142 E MAUMEE ST STE 3
ADRIAN, MI 49221
Lenawee County (517) 263-5810
KIMBERLY A OLMSTED LMSW
Social Worker (Clinical)
142 E MAUMEE ST STE 3
ADRIAN, MI 49221
Lenawee County (517) 263-5810
AARON GLOVIER
Social Worker (Clinical)
142 E MAUMEE ST STE 3
ADRIAN, MI 49221
Lenawee County (517) 263-5810
HANNAH MICHELLE GASPAR MSW
Social Worker (Clinical)
142 E MAUMEE ST STE 3
ADRIAN, MI 49221
Lenawee County (517) 263-5810
RYAN PATRICK DEVLIN
Counselor
142 E MAUMEE ST STE 3
ADRIAN, MI 49221
Lenawee County (517) 263-5810
JANICE M BUCHIN LMSW ACSW
Social Worker (Clinical)
142 E MAUMEE ST STE 3
ADRIAN, MI 49221
Lenawee County (517) 263-5810

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 Jake Fuller's NPI number?

The NPI number for Jake Fuller is 1477313815. It was assigned to this individual provider in the NPPES registry on March 21, 2024.

Where is Jake Fuller located?

Jake Fuller practices at 142 E Maumee St Ste 3, Adrian, MI 49221. The listed phone number is (312) 718-4221.

What is Jake Fuller's specialty?

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

Is Jake Fuller enrolled in Medicare?

Yes. Jake Fuller is registered in the Medicare PECOS enrollment system.

What insurance does Jake Fuller accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian and McLaren Health Plan Community list Jake Fuller 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 Jake Fuller was last updated on April 13, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.