Organization
ERIC FULLEN LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ERIC FULLEN (THERAPIST)
(612) 817-3371
Entity
Organization
Contact information
Practice address
393 GARDEN AVE, HOLLAND, MI 49424-9602
(616) 287-5966
Mailing address
393 GARDEN AVE, HOLLAND, MI 49424-9602
(616) 287-5966
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
01/23/2026
Last updated
03/09/2026
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