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Xavier Quamaine Lee Fullerton, LPC-A,CRC
Mental Health Counselor in Winston Salem, North Carolina
NPI 1215490966

Xavier Quamaine Lee Fullerton is a Mental Health Counselor based in Charlotte, NC and is specialized in Mental Health. Xavier Quamaine Lee Fullerton practices in Winston Salem, NC and has the professional credentials of LPC-A,CRC. The NPI Number for Xavier Quamaine Lee Fullerton is 1215490966 and holds a License No. A14556 (North Carolina).

The current practice location address for Xavier Quamaine Lee Fullerton is 140 Kimel Park Dr Ste 101, Winston Salem, NC and can be reached out via phone at 336-718-7280 and via fax at 336-718-7290.

Location: 140 Kimel Park Dr Ste 101, Winston Salem, NC, 28260-0447
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1215490966
Provider Name
Xavier Quamaine Lee Fullerton
Credential
LPC-A,CRC
Provider Entity Type
Individual
Gender
Male
Address
140 Kimel Park Dr Ste 101, Winston Salem, NC, 28260-0447
Phone Number
336-718-7280
Fax Number
336-718-7290
Provider Enumeration Date
04/10/2019
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
140 Kimel Park Dr Ste 101
City
Winston Salem
State
North Carolina
Zip
27103-6185
Phone Number
336-718-7280
Fax Number
336-718-7290
person
Provider Business Mailing Address Details
Address
140 Kimel Park Dr Ste 101
City
Winston Salem
State
North Carolina
Zip
27103-6185
Phone Number
336-718-7280
Fax Number
336-718-7290
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
101YM0800X
License No.
14556 (North Carolina)
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Professional
Taxonomy
101YP2500X
License No.
()
Definition
Definition to come...
person
Provider's Taxonomy Details 3
Type
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Classification
Rehabilitation Counselor
Speciality
-
Taxonomy
225C00000X
License No.
A14556 (North Carolina)
Definition
An individual trained and educated in a systematic process of assisting persons with physical, mental, developmental, cognitive, and emotional disabilities to achieve their personal, career, and independent living goals assessment and appraisal, diagnosis and treatment planning, career (vocational) counseling, individual and group counseling interventions for adjustments to the medical and psychosocial impact of disability, case management, program evaluation and research, job analysis and placement counseling, and consultation on rehabilitation resources and technology. Certification generally requires a Master's degree with specialized courses in rehabilitation processes and technology.
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