Individual
AMANDA SHEA FULLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, LPC
Contact information
Practice address
4356 MONTEBELLO DR UNIT 25721, COLORADO SPRINGS, CO 80936-0025
(719) 480-8989
Mailing address
4356 MONTEBELLO DR UNIT 25721, COLORADO SPRINGS, CO 80936-0025
(719) 623-4808
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
15448
CO
101YM0800X
Mental Health Counselor
Primary
16832
CO
Other
Enumeration date
02/26/2019
Last updated
04/02/2026
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