Healthcare Provider Details

I. General information

NPI: 1427915685
Provider Name (Legal Business Name): ARIANNA FULLER MA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/08/2026
Last Update Date: 01/09/2026
Certification Date: 01/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 ARAPAHOE AVE STE 10
BOULDER CO
80302-5815
US

IV. Provider business mailing address

100 ARAPAHOE AVE STE 10
BOULDER CO
80302-5815
US

V. Phone/Fax

Practice location:
  • Phone: 720-442-0946
  • Fax: 720-590-6618
Mailing address:
  • Phone: 720-442-0946
  • Fax: 720-590-6618

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLPCC.0022250
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: