Mr Jeffrey Ray Fulkerson, M ED, MS, LAC, LPC in Tempe, AZ

Mr Jeffrey Ray Fulkerson, M ED, MS, LAC, LPC is a medicare enrolled "Counselor - Professional" provider in Tempe, Arizona. His current practice location is 3920 S Rural Rd Ste 112, Tempe, Arizona. You can reach out to his office (for appointments etc.) via phone at (480) 428-2944.

Mr Jeffrey Ray Fulkerson is licensed to practice in Arizona (license number LPC-21211) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1417457623.

Contact Information

	Mr Jeffrey Ray Fulkerson, M ED, MS, LAC, LPC
	3920 S Rural Rd Ste 112, Tempe, AZ 85282-5500
	(480) 428-2944
	(480) 680-5361

Map and Direction

Healthcare Provider's Profile

Full Name	Mr Jeffrey Ray Fulkerson
Gender	Male
Speciality	Counselor - Professional
Location	3920 S Rural Rd Ste 112, Tempe, Arizona
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1417457623
Provider Enumeration Date: 02/14/2018
Last Update Date: 12/22/2023

Medicare PECOS Information:

PECOS PAC ID: 8820440621
Enrollment ID: I20240117002594

Medical Identifiers

Medical identifiers for Mr Jeffrey Ray Fulkerson such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1417457623	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
101YP2500X	Counselor - Professional	LPC-21211 (Arizona)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Mr Jeffrey Ray Fulkerson allows following entities to bill medicare on his behalf.

Entity Name	Aj Southwest Ventures Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1639880917 PECOS PAC ID: 8224480090 Enrollment ID: O20240117001778

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr Jeffrey Ray Fulkerson is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Mr Jeffrey Ray Fulkerson, M ED, MS, LAC, LPC 3920 S Rural Rd Ste 112, Tempe, AZ 85282-5500 Ph: (480) 428-2944	Mr Jeffrey Ray Fulkerson, M ED, MS, LAC, LPC 3920 S Rural Rd Ste 112, Tempe, AZ 85282-5500 Ph: (480) 428-2944

Reviews and Comments

Counselor in Tempe, AZ

Lorre Royanne Anderson, MS, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 4025 S Mcclintock Dr # 212, Tempe, AZ 85282 Phone: 480-278-9024
Mr. William Saunders, L.P.C. Counselor Medicare: Not Enrolled in Medicare Practice Location: 2435 E Southern Ave, Suite 2, Tempe, AZ 85282 Phone: 480-241-2455
Carly Ann Welch, Counselor Medicare: Not Enrolled in Medicare Practice Location: 2120 S Mcclintock Dr Ste 105, Tempe, AZ 85282 Phone: 480-804-0326 Fax: 480-804-0083
Maria Rose Sarno, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 2120 S Mcclintock Dr Ste 105, Tempe, AZ 85282 Phone: 480-804-0326 Fax: 480-804-0083
Renee Dionisio, Counselor Medicare: Not Enrolled in Medicare Practice Location: 401 W Baseline Rd Ste 210, Tempe, AZ 85283 Phone: 480-307-6446
Ms. Cheryl Lynn Sanders, MC, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 1232 E Broadway Rd, Suite #120, Tempe, AZ 85282 Phone: 480-784-1514
Jamie L Hancock, LAC Counselor Medicare: Medicare Enrolled Practice Location: 2120 S Mcclintock Dr, Suite 105, Tempe, AZ 85282 Phone: 480-804-0326 Fax: 480-804-0083

Mr Jeffrey Ray Fulkerson, M ED, MS, LAC, LPC - Medicare Counselor in Tempe, AZ