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General NPI Number Information
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NPI Number | 1265359905
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Entity Type | Individual
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Provider Name | MELISSA M FULLAM LPC-C
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Gender | Female
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Dates
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Enumeration Date | 07/02/2026
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Last Update Date | 07/02/2026
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Provider Practice Location Address
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Address Line | 9200 E MINERAL AVE STE 250
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City | CENTENNIAL
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State | CO
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Zip | 80112-3459
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Country | US
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Telephone | 303-798-2196
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Fax | 303-730-2418
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Provider Business Mailing Address
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Address Line | 7254 S XENIA CIR APT D
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City | CENTENNIAL
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State | CO
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Zip | 80112-1941
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Country | US
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Telephone | 303-798-2196
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Fax | 303-730-2418
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | LPCC.0024895
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License Number State | CO
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