DR. ROBERT FUCETOLA (NPI# 1023035656) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023035656 |
| Entity Type | Individual |
| Full Name | DR. ROBERT FUCETOLA |
| Credential | PHD |
| Practice Address |
4444 Forest Park Ave Fl 2 2nd Fl Saint Louis MO 63108-2212 |
| Mailing Address |
660 S Euclid Ave C B 8111 Saint Louis MO 63110-1010 |
| Practice Telephone | 3144547756 |
| Practice Fax Number | 3144547759 |
| Mailing Telephone | 3144547756 |
| Mailing Fax Number | 3144547759 |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2018-01-24 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103G00000X | Clinical Neuropsychologist | 01900 | MO | Behavioral Health & Social Service Providers |
| Street Address |
4444 FOREST PARK AVE FL 2 2ND FL |
| City | SAINT LOUIS |
| State | MO |
| Zip Code | 63108-2212 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700802022 | Nicole J Werner | Clinical Neuropsychologist | 4444 Forest Park Ave Fl 2, 2nd Fl, Saint Louis, MO 63108-2212 | 2006-07-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346851474 | Nigel Austen Thomas Cook | Social Worker | 4050 West Pine Blvd. Apt. 4118, St. Louis, MO 63108 | 2020-08-12 |
| 1467070011 | C2n Diagnostics, LLC | Clinical Medical Laboratory | 20 South Sarah Street, Saint Louis, MO 63108 | 2020-07-10 |
| 1609414358 | Kaylee Breitenbucher | Occupational Therapist | 4444 Forest Park Avenue, Msc 8505-94-01, St. Louis, MO 63108 | 2019-12-12 |
| 1114419546 | Activangels Home Health | Home Health | 4625 Lindell Blvd Ste 304, Saint Louis, MO 63108 | 2018-06-01 |
| 1215427349 | Heart To Heart Consolidated Home Care Service LLC | Home Health | 4625 Lindell Blvd Ste 200, Saint Louis, MO 63108 | 2018-05-15 |
| 1447755905 | Erin Virginia Adams | Student in an Organized Health Care Education/Training Program | 4355 Maryland Ave Apt 116, Saint Louis, MO 63108 | 2018-03-27 |
| 1033621172 | Roots Healthcare and Homes | In Home Supportive Care | 4300 Enright Ave, St. Louis, MO 63108 | 2017-10-30 |
| 1336661719 | House of Destiny Adult Day Care LLC | Clinic/Center | 4507 Olive Street, St Louis, MO 63108 | 2017-07-07 |
| 1003338492 | Khin Min Thu | Social Worker | 4236 Lindell Blvd., Suite 200, St Louis, MO 63108 | 2017-07-07 |
| 1679093967 | Together We Can Home Healthcare Services LLC | Home Health | 4144 Lindell Blvd Suite 221, Saint Louis, MO 63108 | 2017-06-27 |
| Find all providers in zip 63108 | ||||
| Taxonomy Code | 103G00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Clinical Neuropsychologist |
| An individual with a doctorate degree, licensure in clinical psychology and specialized training or board certification in neuropsychology who practices or adheres to the principles of neuropsychology; a specialty within the field of psychology focusing primarily on neurobehavioral functioning. |
| Notes: Source: American Psychological Association, Washington, DC, 1997. [1/1/2007: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144873159 | Stephanie Ross Potts | Clinical Neuropsychologist | 1027 Bellevue Ave Ste 142, Saint Louis, MO 63117-1851 | 2019-07-18 |
| 1508259003 | Maria Catherine Rothhaar | Clinical Neuropsychologist | 522 N New Ballas Rd Ste 121, Saint Louis, MO 63141-6820 | 2015-03-09 |
| 1689852253 | Stacey Woodrome | Clinical Neuropsychologist | 3800 Park Ave Fl 2, Saint Louis, MO 63110-2514 | 2008-02-06 |
| 1700802022 | Nicole J Werner | Clinical Neuropsychologist | 4444 Forest Park Ave Fl 2, 2nd Fl, Saint Louis, MO 63108-2212 | 2006-07-14 |
| 1477539237 | Rehab Care Group East Inc | Clinical Neuropsychologist | 7733 Forsyth Blvd, Suite 2300, Saint Louis, MO 63105-1817 | 2005-12-22 |
| 1366910572 | Evan Ti Schulze | Clinical Neuropsychologist | 1438 S Grand Blvd, Saint Louis, MO 63104-1027 | 2018-11-06 |
| 1912374398 | Victoria Herberger | Clinical Neuropsychologist | 615 S New Ballas Rd, Mercy Neuropsychology Service, Saint Louis, MO 63141-8221 | 2015-09-01 |
| 1013317700 | Christopher Bosworth | Clinical Neuropsychologist | 1 Childrens Pl, Suite 3n-14, Saint Louis, MO 63110-1002 | 2014-08-29 |
| 1871929687 | Gabriel Araujo | Clinical Neuropsychologist | 1 Childrens Pl, Suite 3 South 32, Saint Louis, MO 63110-1002 | 2013-09-25 |
| 1861771206 | Phillip D. Ruppert | Clinical Neuropsychologist | 1438 S Grand Blvd, Saint Louis, MO 63104-1027 | 2011-08-16 |
| Find all providers in SAINT LOUIS | ||||
| City | SAINT LOUIS |
| Zip Code | 63108 |
Please comment or provide details below to improve the information on DR. ROBERT FUCETOLA.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.