Individual provider · Type 1 NPI

Kacie Lee Fuller, MA

Mental Health Counselor · Salem, OR

NPI number 1265340962 Active

Practice location

3855 Wolverine St NE Bldg A
Salem, OR 97305-1251

Call (971) 375-1523 Map

Mailing address

657 SE Cooper St
Dallas, OR 97338-1945

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XR10158 (OR)

Mental Health Counselor: Definition to come...

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About NPI 1265340962

Kacie Lee Fuller, MA's National Provider Identifier is 1265340962, issued on Sep 1, 2026. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Salem, OR. The record was last updated on Sep 1, 2026.