1. Home
  2. Directory
  3. Georgia
  4. Villa Rica
  5. Counselor
  6. NPI Profile

LARRY DEWITT FULLER JR. M.A.
NPI 1700209327
Counselor - Professional in Villa Rica, GA

Active since February 03, 2014
307 OLD STONE RD, VILLA RICA, GA 30180(770) 459-8799 Get Directions Write a Review

NPPES record last updated: February 3, 2014. Verified against the NPPES registry weekly; last sync: September 06, 2026.

About Larry Dewitt Fuller Jr. M.a. NPPES

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

LARRY DEWITT FULLER JR. M.A. (NPI 1700209327) is an individual professional provider in Villa Rica, Georgia, licensed in Georgia (LPC007525) and active in the NPI registry since February 2014.

NPPES Registry Identity

NPI1700209327
Entity TypeIndividualMale
Primary Taxonomy101YP2500X
Provider Legal NameLARRY DEWITT FULLER JR.Credential: M.A.
Location Address307 OLD STONE RDVilla Rica, GA 30180-1214
Mailing Address6439 Briarwood CtRiverdale, GA 30296-2904 · (404) 433-0307
Phone(770) 459-8799
Sole ProprietorNo
Enumeration DateFebruary 3, 2014
✔ NPI 1700209327 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 GA · LPC007525
307 OLD STONE RD, Villa Rica, GA 30180
Open in Google Maps ↗

Other Providers at the Same Location NPPES 5

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

MR. JASON FORDYCE PMHNP-BC
Nurse Practitioner (Psychiatric/Mental Health)
307 OLD STONE RD
VILLA RICA, GA 30180
Carroll County (770) 459-8799
POTTERS HANDS INSTITUTE LLC
Clinic/Center (Rehabilitation, Substance Use Disorder)
307 OLD STONE RD
VILLA RICA, GA 30180
Carroll County (770) 459-8799
OMOBOLAJI OLUSEYI OYEBANJO POPOOLA MD
Psychiatry & Neurology (Addiction Psychiatry)
307 OLD STONE RD
VILLA RICA, GA 30180
Carroll County (770) 459-8799
MARDEEA JARTU LPC
Counselor (Professional)
307 OLD STONE RD
VILLA RICA, GA 30180
Carroll County (770) 459-8799
MOBOLAJI SHALOM OYEBANJO, INC
Psychiatry & Neurology (Psychiatry)
307 OLD STONE RD
VILLA RICA, GA 30180
Carroll County (770) 459-8799

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 Larry Fuller's NPI number?

The NPI number for Larry Fuller is 1700209327. It was assigned to this individual provider in the NPPES registry on February 3, 2014.

Where is Larry Fuller located?

Larry Fuller practices at 307 Old Stone Rd, Villa Rica, GA 30180. The listed phone number is (770) 459-8799.

What is Larry Fuller's specialty?

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

When was this NPI record last updated?

The NPPES record for Larry Fuller was last updated on February 3, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.