| Fuller Counseling And Consulting, Pllc | |
|
3201 University Dr E Ste 150 Bryan TX 77802-3487 | |
| (979) 777-5545 | |
| Not Available |
| Full Name | Fuller Counseling And Consulting, Pllc |
|---|---|
| Speciality | Counselor |
| Location | 3201 University Dr E Ste 150, Bryan, Texas |
| Authorized Official Name and Position | Charles Robert Fuller (OWNER) |
| Authorized Official Contact | 9797775545 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Fuller Counseling And Consulting, Pllc 3201 University Dr E Ste 150 Bryan TX 77802-3487 Ph: (979) 777-5545 | Fuller Counseling And Consulting, Pllc 3201 University Dr E Ste 150 Bryan TX 77802-3487 Ph: (979) 777-5545 |
| NPI Number | 1518647627 |
|---|---|
| Provider Enumeration Date | 07/24/2023 |
| Last Update Date | 09/20/2023 |
| Certification Date | 09/20/2023 |
| Medicare PECOS PAC ID | 8224472188 |
|---|---|
| Medicare Enrollment ID | O20240219002586 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518647627 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
| Provider Name | Charles R Fuller |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1952845240 PECOS PAC ID: 9830533793 Enrollment ID: I20240219002795 |
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