LISA BARRY FULLER – Professional Counselor, NPI 1407407372

LISA BARRY FULLER is a healthcare provider. based in Dothan, Alabama. specializing in MENTAL HEALTH COUNSELOR. They hold a License No. 3364 (AL). The NPI Number for LISA BARRY FULLER is 1407407372

Main info

Female
21 Years Of Experience
Accepts Medicare Assignment
Name
LISA BARRY FULLER
NPI
1407407372
Phone
(334) 712-6400
Address
1672 COLUMBIA HWY
Enumeration Date
23 September 2019
Last Update Date
23 September 2019

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3347122720
Graduation Year
2005 (21 years ago)
PAC ID
0345684197
Group Practice PAC ID
3779509765
Professional Enrollment ID
I20240220002272
Address ID
AL363032165DO3542XHWYX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience26
Completeness75
Years active:6State licenses:1Digital endpointsOther names

390 MENTAL HEALTH COUNSELOR in AL

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Provider Addresses for LISA BARRY FULLER

  • 1672, Columbia Highway, Dothan, Houston County, Alabama, 36303, United States

    DOTHAN, AL 363035434

    Phone: (334) 712-6400

    Fax: (334) 712-2676

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-02-20

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20240220002272IMental Health CounselorALTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 36303)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 3779509765View full group profile
NameSpecialtyState
P S Y C H I A T R YTN
Mental Health CounselorAL
Family PracticeFL
Mental Health CounselorAL
Mental Health CounselorAL
Mental Health CounselorAL
Mental Health CounselorAL
Nurse PractitionerAL
P S Y C H I A T R YAL
Mental Health CounselorAL

Reviews

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Frequently asked questions

Is LISA BARRY FULLER listed with a National Provider Identifier?
Yes — LISA BARRY FULLER has NPI 1407407372 on file in the registry.
Active or inactive — what applies to LISA BARRY FULLER?
You should see LISA BARRY FULLER as active in CMS-hosted NPPES data.
What area of care is associated with LISA BARRY FULLER?
LISA BARRY FULLER's record emphasizes Professional Counselor. Clinical services aligned with this taxonomy classification.
What practice footprint exists for LISA BARRY FULLER?
Travel planning: use Dothan, Alabama as the reference point for LISA BARRY FULLER, then confirm.
When was this NPI issued?
Enumeration for LISA BARRY FULLER is noted as September 23, 2019 where the registry provides it.

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