| Dr Mickey Joe Fuller, MA, MS, PSYD | |
|
198 E Center St, Moab, UT 84532-2430 | |
| (435) 259-6131 | |
| (435) 259-5369 |
| Full Name | Dr Mickey Joe Fuller |
|---|---|
| Gender | Male |
| Speciality | Clinical Psychologist |
| Experience | 25 Years |
| Location | 198 E Center St, Moab, Utah |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427017573 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 5329261-6006 (Utah) | Secondary |
| 101YP2500X | Counselor - Professional | 5329261-6010 (Utah) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Therapy Associates Pc | 3173882065 | 9 |
| Entity Name | Therapy Associates Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1578703468 PECOS PAC ID: 3173882065 Enrollment ID: O20180123001292 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Mickey Joe Fuller, MA, MS, PSYD 3310 Spanish Valley Dr, Moab, UT 84532-3636 Ph: (801) 953-3113 | Dr Mickey Joe Fuller, MA, MS, PSYD 198 E Center St, Moab, UT 84532-2430 Ph: (435) 259-6131 |
Amber Dawn Fowler, CMHC Counselor Medicare: Not Enrolled in Medicare Practice Location: 50 E Center St Ste 7, Moab, UT 84532 Phone: 435-200-5551 Fax: 435-344-4604 | |
Pippa S Thomas, CMHC Counselor Medicare: Not Enrolled in Medicare Practice Location: 50 E Center St Ste 8, Moab, UT 84532 Phone: 435-220-1012 | |
Richard Donham, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 198 East Center Street, Moab, UT 84532 Phone: 435-259-6131 Fax: 435-259-5369 | |
Mr. Ammon Sorensen, APC Counselor Medicare: Not Enrolled in Medicare Practice Location: 198 E Center St, Moab, UT 84532 Phone: 435-259-6131 Fax: 435-259-5369 | |
Belinda Lou Hurst, CMHC Counselor Medicare: Not Enrolled in Medicare Practice Location: 198 East Center Street, Moab, UT 84532 Phone: 435-259-6131 Fax: 435-259-5369 | |
Mr. Robert Isadore Greenberg, LMHC Counselor Medicare: Not Enrolled in Medicare Practice Location: 198 East Center Street, Moab, UT 84532 Phone: 435-259-6131 Fax: 435-259-5369 |