MS. NICOLE M FULLER (NPI# 1073578969) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073578969 |
| Entity Type | Individual |
| Full Name | MS. NICOLE M FULLER |
| Credential | LCSW, BCD |
| Practice Address |
1050 W. Perimeter Road Suite B5-19 779 Medical Group Andrews Afb MD 20762 |
| Practice Telephone | 2408577186 |
| Enumeration Date | 2006-04-20 |
| Last Update Date | 2012-07-10 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
35461 | TX | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922615210 | Nicole Fuller | Dietitian, Registered | 11 Austin Pl, Glen Rock, NJ 07452-1701 | 2020-09-30 |
| 1407178460 | Nicole Marie Fuller | Registered Nurse | 106 4th Ave. N, Fergus Falls, MN 56537-1034 | 2010-02-18 |
| 1952803975 | Nicole Fuller | Registered Nurse | 2500 N 67th St, Lincoln, NE 68507-2807 | 2018-03-06 |
| 1700054491 | Nicole C. Fuller | Counselor | 601 Cleveland Ave Nw, Canton, OH 44702-1836 | 2008-02-14 |
| 1083742993 | Nicole Middleton Fuller | Nurse Practitioner | 2516 Broadmoor Blvd, Monroe, LA 71201-2988 | 2007-03-01 |
| Street Address |
1050 W. PERIMETER ROAD SUITE B5-19 779 MEDICAL GROUP |
| City | ANDREWS AFB |
| State | MD |
| Zip Code | 20762 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982210423 | Kevin Wang | Dentist | 1057 W Perimeter Rd, Prince County, MD 20762 | 2020-09-21 |
| 1306467667 | Priscilla Andalia | Student in an Organized Health Care Education/Training Program | 1065 W. Perimeter Road, Jb Andrews, MD 20762 | 2020-04-28 |
| 1275162877 | Gabi Im | Dentist | 1065 W Perimeter Rd., Joint Base Andrews, Apo, AA 20762 | 2020-04-06 |
| 1083240139 | Shirley Ye | Student in an Organized Health Care Education/Training Program | 1025 Boston Rd, Joint Base Andrews, MD 20762 | 2020-03-20 |
| 1255988853 | Songxuan Zhou Niemtzow | Acupuncturist | Acupuncture Center and Integrative Medicine Center, 1060 West Perimeter Road, Joint Base Andrews, MD 20762 | 2019-08-20 |
| 1487010971 | Tracy Ellen Ambos | Social Worker | 5100 Fetcher Avenue, Joint Base Andrews, MD 20762 | 2016-01-13 |
| 1154718450 | Ryan Mason Kring | Emergency Medicine | Malcolm Grow Medical Clinics, 1060 W Perimeter Rd, Joint Base Andrews, MD 20762 | 2015-04-24 |
| 1518206044 | Jeremy Gallman | Veterinarian | 1781 Arnold Ave., Joint Base Andrews, MD 20762 | 2013-02-04 |
| 1043556418 | Kimberly Mccoy-singh | Physical Therapist | 1075 West Perimeter Rd., 779 Mdos/sgoy, Joint Base Andrews, MD 20762 | 2012-12-12 |
| 1417215799 | Alexander Rostam Kheradi | Emergency Medicine | 1050 West Perimeter Road, Joint Base Andrews, MD 20762 | 2012-04-24 |
| Find all providers in zip 20762 | ||||
| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| A social worker who holds a master’s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master’s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. |
| Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285916601 | Janet Denise Cochran | Social Worker | 1050 W Perimeter Rd, Andrews Afb, MD 20762-6601 | 2011-09-12 |
| 1659454791 | Nicole Garris | Social Worker | 1050 W Perimeter Rd, #56, Andrews Afb, MD 20762-6601 | 2006-10-23 |
| 1427146612 | Suzanne Reed Scheddel | Social Worker | 1050 W Perimeter Rd, Ste A4, Andrews Afb, MD 20762-6601 | 2006-10-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508467069 | Pivot Inc. | Social Worker | 1725 E Baltimore St, Baltimore, MD 21231-1508 | 2020-11-02 |
| 1265033716 | Estell Wellness, LLC | Social Worker | 3925 Beech Ave Apt 522, Baltimore, MD 21211-2265 | 2020-11-02 |
| 1669073201 | Deborah Lynn Dey | Social Worker | 810 Bestgate Rd Ste 400, Annapolis, MD 21401-3033 | 2020-11-02 |
| 1265032908 | Ayana S Manzanares | Social Worker | 2507 Holman Ave, Silver Spring, MD 20910-1143 | 2020-10-30 |
| 1669072633 | Petals Behavioral LLC | Social Worker | 12623 Epping Rd, Silver Spring, MD 20906-3865 | 2020-10-29 |
| 1972103752 | Tasha Williams | Social Worker | 3025 Woodring Ave, Parkville, MD 21234-7828 | 2020-10-29 |
| 1821698853 | Britney Buckson | Social Worker | 3710 Mary Ave, Baltimore, MD 21206-2416 | 2020-10-28 |
| 1467052746 | Allison Clayton | Social Worker | 1206 Union Ave, Baltimore, MD 21211-1901 | 2020-10-27 |
| 1841890043 | Juliet Renee Wilson | Social Worker | 1811 Chapel Rd, Havre De Grace, MD 21078-1809 | 2020-10-27 |
| 1457951618 | Betsy Reinstein Dewey | Social Worker | 4618 Derussey Pkwy, Chevy Chase, MD 20815-5332 | 2020-10-27 |
| Find all providers with the same taxonomy | ||||
| City | ANDREWS AFB |
| Zip Code | 20762 |
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| 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.