Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Jacqueline Fullwood

Individual provider Counselor · NPI 1649923582

Jacqueline Fullwood is a Mental Health Counselor in Nashville, Tennessee. Qualified in 2020, 6 years ago. Licensed in Tennessee.

Years since qualifying
6
Licensed in
TN
In the registry since
2022
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Practice location Address checks out

2000 Glen Echo Rd Ste 101
Nashville, TN 37215-2857
Phone: (615) 457-8585
Fax: (615) 457-8595
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Counselor (primary) Taxonomy 101Y00000X (TN)

Record details

NPI number1649923582
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedFebruary 1, 2022
Last updated in NPPESFebruary 1, 2022
Certification dateFebruary 1, 2022
Mailing address2000 Glen Echo Rd Ste 101, Nashville, TN 37215-2857

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyMENTAL HEALTH COUNSELOR
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Accepts Medicare assignment Not indicated

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