JACQUELINE FULLWOOD
NPI 1649923582
Counselor in Nashville, TN

Q: What is Jacqueline Fullwood's NPI number?

The NPI number for Jacqueline Fullwood is 1649923582. It was assigned to this individual provider in the NPPES registry on February 1, 2022.

Q: What is Jacqueline Fullwood's specialty?

The primary specialty registered for this NPI is Counselor with taxonomy code 101Y00000X.

Active since February 01, 2022PECOS Enrolled

2000 GLEN ECHO RD STE 101, NASHVILLE, TN 37215(615) 457-8585(615) 457-8595 Get Directions Write a Review

NPPES record last updated: February 1, 2022. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Jacqueline Fullwood NPPES

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

JACQUELINE FULLWOOD (NPI 1649923582) is an individual counselor in Nashville, Tennessee and active in the NPI registry since February 2022. She is enrolled in Medicare PECOS and is a graduate of Other (2020).

NPPES Registry Identity

NPI1649923582

Entity TypeIndividualFemale

Primary Taxonomy101Y00000X

Provider Legal NameJACQUELINE FULLWOOD

Location Address2000 GLEN ECHO RD STE 101Nashville, TN 37215-2857

Mailing Address2000 Glen Echo Rd Ste 101Nashville, TN 37215-2857 · (615) 457-8585 · Fax (615) 457-8595

Phone(615) 457-8585

Fax(615) 457-8595

Sole ProprietorNo

Medical School CMSOtherGraduated 2020

Enumeration DateFebruary 1, 2022

NPPES CertifiedFebruary 1, 2022

✔ NPI 1649923582 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselorBehavioral Health & Social Service Providers

Taxonomy Code101Y00000X

Definition

A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.

2000 GLEN ECHO RD STE 101, Nashville, TN 37215

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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jacqueline Fullwood is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID648744433

PECOS Enrollment IDI20260702000953

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 6

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

DR. TIANLAI TANG M.D

Psychiatry & Neurology (Psychiatry)