Individual
SUZANNE FULKERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMHC, LMFT
Contact information
Practice address
205 N COLLEGE AVE, SUITE 613, BLOOMINGTON, IN 47404-3950
(812) 334-2858
Mailing address
205 N COLLEGE AVE, SUITE 613, BLOOMINGTON, IN 47404-3950
(812) 334-2858
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
39000832A
IN
106H00000X
Marriage & Family Therapist
Primary
35000589A
IN
Other
Enumeration date
05/10/2007
Last updated
09/11/2025
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