DR. STEFFEN R. FULLER (NPI# 1467598961) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467598961 |
| Entity Type | Individual |
| Full Name | DR. STEFFEN R. FULLER |
| Credential | PH.D. |
| Practice Address |
68 Leonard St Belmont MA 02478-2522 |
| Practice Telephone | 6174845005 |
| Practice Fax Number | 6174845005 |
| Mailing Telephone | 6174845005 |
| Mailing Fax Number | 6174845005 |
| Enumeration Date | 2007-01-30 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103G00000X | Clinical Neuropsychologist | 4977 | MA | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MA | BCBS | WO4682 | 01 |
| Street Address |
68 LEONARD ST |
| City | BELMONT |
| State | MA |
| Zip Code | 02478-2522 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487663522 | Sherri A Mello | Psychiatry & Neurology | 68 Leonard St, Suite 307, Belmont, MA 02478-2522 | 2006-08-07 |
| 1841485448 | Carol Henderson Evans | Social Worker | 68 Leonard St, Suite 306, Belmont, MA 02478-2522 | 2007-09-07 |
| 1184848327 | Lois Jean Keithly | Psychologist | 68 Leonard St, Belmont, MA 02478-2522 | 2007-04-12 |
| 1568506137 | John Edgar Baker | Psychologist | 68 Leonard St, 2nd Floor, Belmont, MA 02478-2522 | 2007-02-16 |
| 1700928587 | Judith Anne Ashway | Social Worker | 68 Leonard St, 2nd Floor, Belmont, MA 02478 | 2007-02-12 |
| 1558407064 | Fuller Consulting Services, LLC | Clinical Neuropsychologist | 68 Leonard St, Belmont, MA 02478-2522 | 2007-01-30 |
| 1598824922 | Manuela Paola Mcshane | Counselor | 68 Leonard St, Suite 306, Belmont, MA 02478-2522 | 2006-12-08 |
| 1396858411 | Elizabeth Torres | Psychologist | 68 Leonard St, Suite 304, Belmont, MA 02478-2522 | 2006-08-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760089924 | Emily Boyko | Physical Therapist | 413 Trapelo Rd, 2, Belmont, MA 02478 | 2020-10-01 |
| 1326695636 | Kristen Perrelli | Social Worker | 115 Mill Street Mail Stop 207, Belmont, MA 02478 | 2019-08-21 |
| 1265905210 | Deborah J Fenn | Social Worker | 88 Palfrey Rd, Belmont, MA 02478 | 2019-01-02 |
| 1922578855 | The Psych Garden LLC | Counselor | 25 Flanders Road, Belmont, MA 02478 | 2018-12-04 |
| 1083199855 | Wendi Goldberg | Social Worker | 1 15 Mill Street, Belmont, MA 02478 | 2018-09-27 |
| 1124514146 | Ann Polcari | Clinical Nurse Specialist | Service Building Mc Lean Hospital, 115 Mill Street, Belmont, MA 02478 | 2018-07-02 |
| 1245722701 | Jeremy Stewart | Psychologist | Mclean Hospital, 115 Mill Street, Mailstop 331, Belmont, MA 02478 | 2018-05-31 |
| 1295257848 | Stephanie Boyer | Psychologist | Mclean Hospital, 115 Mill St., Mail Stop 131, Belmont, MA 02478 | 2017-07-14 |
| 1497281893 | The Meraki Center for Therapeutic Arts | Community/Behavioral Health | 431 Trapelo Rd, Belmont, MA 02478 | 2017-05-04 |
| 1275908063 | Alex Jordan | Psychologist | 115 Mill Street, Mail Stop 217, Mclean Hospital, Belmont, MA 02478 | 2015-12-05 |
| Find all providers in zip 02478 | ||||
| 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 |
|---|---|---|---|---|
| 1902932536 | Simon Tan | Clinical Neuropsychologist | 3415 Beresford Ave, Belmont, CA 94002-1301 | 2007-02-26 |
| 1063563427 | Lee C Reich | Clinical Neuropsychologist | 23 Oak St, Belmont, MA 02478-3006 | 2007-01-14 |
| 1407927569 | Lillian Brandon Dinklage | Clinical Neuropsychologist | 10 Ivy Rd, Belmont, MA 02478-3364 | 2006-11-12 |
| 1275586794 | Mithlesh N/a Garg | Clinical Neuropsychologist | 19 Larch Cir, Belmont, MA 02478-4612 | 2006-05-18 |
| 1184600215 | Ronald James Calvanio | Clinical Neuropsychologist | 89 Bay State Rd, Belmont, MA 02478-2240 | 2005-12-20 |
| 1922358969 | Kathryn Piscitelle | Clinical Neuropsychologist | 115 Mill St, Belmont, MA 02478-1064 | 2012-09-18 |
| 1881831493 | Michael Leo Brinkman | Clinical Neuropsychologist | 115 Mill St, South Belknap 3, Belmont, MA 02478-1064 | 2009-01-20 |
| 1558407064 | Fuller Consulting Services, LLC | Clinical Neuropsychologist | 68 Leonard St, Belmont, MA 02478-2522 | 2007-01-30 |
| 1679637037 | Julie Michelle Brody Magid | Clinical Neuropsychologist | 115 Mill St, Belmont, MA 02478-1064 | 2006-12-20 |
| 1205817723 | Jennifer White | Clinical Neuropsychologist | 115 Mill St, Mclean Hospital, Belmont, MA 02478-1041 | 2005-11-10 |
| Find all providers in BELMONT | ||||
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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.