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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

NICOLE FULLER-DOUGLAS
NPI 1740019561
Counselor - Professional in Ionia, MI

Active since July 30, 2024
375 APPLE TREE DR, IONIA, MI 48846(616) 527-1790(616) 527-0538 Get Directions Write a Review

NPPES record last updated: August 19, 2026. Verified against the NPPES registry weekly; last sync: August 30, 2026.

Record update history: Aug 19, 2026, Jul 14, 2026, Jul 30, 2024 (3 updates tracked since 2024).

About Nicole Fuller-douglas NPPES

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

NICOLE FULLER-DOUGLAS (NPI 1740019561) is an individual professional provider in Ionia, Michigan, licensed in Michigan (6401226426) and active in the NPI registry since July 2024.

NPPES Registry Identity

NPI1740019561
Entity TypeIndividualFemale
Primary Taxonomy101YP2500X
Provider Legal NameNICOLE FULLER-DOUGLAS
Location Address375 APPLE TREE DRIonia, MI 48846-7506
Mailing Address375 Apple Tree DrIonia, MI 48846-7506 · (616) 527-1790 · Fax (616) 527-0538
Phone(616) 527-1790
Fax(616) 527-0538
Sole ProprietorNo
Enumeration DateJuly 30, 2024
Last NPPES UpdateAugust 19, 20263 updates tracked since enumeration
NPPES CertifiedAugust 19, 2026
✔ NPI 1740019561 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 · 6401226426
375 APPLE TREE DR, Ionia, MI 48846
Open in Google Maps ↗

Other Identifiers 1

Medicaid1740019561MI

Other Providers at the Same Location NPPES 20

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

MACIE REED
Assistant Behavior Analyst
375 APPLE TREE DR
IONIA, MI 48846
Ionia County (616) 527-1790
JONNA MALAVE
Behavior Technician
375 APPLE TREE DR
IONIA, MI 48846
Ionia County (616) 527-1790
MINH CONG HOANG LMSW
Social Worker
375 APPLE TREE DR
IONIA, MI 48846
Ionia County (616) 527-1790
MADISON JEAN KORESH MA, BCBA
Behavior Analyst
375 APPLE TREE DR
IONIA, MI 48846
Ionia County (616) 527-1790
TONY PACHECO LUIS
Behavior Technician
375 APPLE TREE DR
IONIA, MI 48846
Ionia County (616) 527-1790
ALEXZANDRA DOTY
Community Health Worker
375 APPLE TREE DR
IONIA, MI 48846
Ionia County (616) 527-1790
MRS. KATIE REBECCA MAGNUSON LLBSW
Social Worker
375 APPLE TREE DR
IONIA, MI 48846
Ionia County (616) 527-1790
CALEB WOOD
Community Health Worker
375 APPLE TREE DR
IONIA, MI 48846
Ionia County (616) 527-1790

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 Nicole Fuller-douglas's NPI number?

The NPI number for Nicole Fuller-douglas is 1740019561. It was assigned to this individual provider in the NPPES registry on July 30, 2024.

Where is Nicole Fuller-douglas located?

Nicole Fuller-douglas practices at 375 Apple Tree Dr, Ionia, MI 48846. The listed phone number is (616) 527-1790.

What is Nicole Fuller-douglas'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 Nicole Fuller-douglas was last updated on August 19, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 20 days 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.