Organization
FFC PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAKE EDWARD FULLER LPC (MANAGING MEMBER)
(312) 718-4221
Entity
Organization
Contact information
Practice address
29532 SOUTHFIELD RD STE 115, SOUTHFIELD, MI 48076-2023
(734) 215-5404
(570) 989-5073
Mailing address
29532 SOUTHFIELD RD STE 115, SOUTHFIELD, MI 48076-2023
(734) 215-5404
(570) 989-5073
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
101YP2500X
Professional Counselor
Primary
—
—
Other
Enumeration date
01/08/2025
Last updated
05/07/2026
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