DR. MICKEY JOE FULLER MA MS PSY.D. NPI 1427017573

NPI Information

  • NPI: 1427017573
  • Provider Name: DR. MICKEY JOE FULLER, MA, MS, PSY.D.
  • Classification: Counselor - 101YP2500X
  • Specialization: Professional
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 198 E CENTER ST
    MOAB, UT
    ZIP 84532
  • Phone: (435) 259-6131

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NPI Details

DR. Mickey Joe Fuller, MA, MS, PSY.D. is a professional counselor in Moab, UT with 26 years of experience. DR. Mickey Joe Fuller, MA, MS, PSY.D. NPI is 1427017573. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

198 E CENTER ST
MOAB, UT
ZIP 84532-430
Phone: (435) 259-6131
Fax: (435) 259-5369

The NPI 1427017573 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment.

The enumeration date for this NPI number is 3/18/2006 and was last updated on 11/9/2009.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1101YA0400XCounselorAddiction (Substance Use Disorder)5329261-6006UTAHNo
2101YP2500XCounselorProfessional5329261-6010UTAHYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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