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

Mr. Jeffrey Ray Fulkerson, MED, MS, LAC, LPC

Individual provider Professional Counselor · NPI 1417457623

Mr. Jeffrey Ray Fulkerson, MED, MS, LAC, LPC is a Mental Health Counselor in Tempe, Arizona. Qualified in 2017, 9 years ago. Licensed in Arizona.

Years since qualifying
9
Licensed in
AZ
In the registry since
2018
What do these letters mean?
MED — Master of Education
A graduate education degree, written M.Ed.
MS — Master of Science
A graduate science degree.
LAC — Licensed Associate Counselor
A counsellor practising under supervision toward full licensure. In some states the same letters mean Licensed Acupuncturist.
LPC — Licensed Professional Counselor
A licensed mental health counsellor.

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Practice location Address checks out

3920 S Rural Rd Ste 112
Tempe, AZ 85282-5500
Phone: (480) 428-2944
Fax: (480) 680-5361
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Professional Counselor (primary) Taxonomy 101YP2500X · Licence LPC-21211 (AZ)

Record details

NPI number1417457623
Entity typeIndividual (Type 1)
GenderMale
Credentials MED , MS , LAC , LPC
Sole proprietorNo
NPI enumeratedFebruary 14, 2018
Last updated in NPPESDecember 22, 2023
Certification dateDecember 22, 2023

Medicare enrollment

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

Medicare specialtyMENTAL HEALTH COUNSELOR
Medical schoolOTHER
Graduated 2017 (9 years in practice)
Accepts Medicare assignment Not indicated

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