CHARMAINE FULLER - NPI 1689359911 - Counselor in Mesa, AZ

Q: What is the provider's specialty?

The provider's specialty is Counselor with taxonomy code 101Y00000X.

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About Charmaine Fuller NPPES

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

CHARMAINE FULLER (NPI 1689359911) is an individual counselor in Mesa, Arizona, licensed in Arizona (LAC-19920) and active in the NPI registry since June 2023.

NPPES Registry Identity

NPI1689359911

Entity TypeIndividualFemale

Primary Taxonomy101Y00000X

Provider Legal NameCHARMAINE FULLER

Location Address7565 E EAGLE CREST DR STE 201Mesa, AZ 85207-1067

Mailing Address7565 E Eagle Crest Dr Ste 201Mesa, AZ 85207-1067 · (480) 788-5069

Phone(480) 788-5069

Sole ProprietorYes

Enumeration DateJune 15, 2023

NPPES CertifiedJune 15, 2023

✔ NPI 1689359911 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselorBehavioral Health & Social Service Providers

Taxonomy Code101Y00000X

License✔ Licensed in AZ · LAC-19920

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.

7565 E EAGLE CREST DR STE 201, Mesa, AZ 85207

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