ANNETTE FULTZ (NPI# 1497154660) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497154660 |
| Entity Type | Individual |
| Full Name | ANNETTE FULTZ |
| Credential | CADC |
| Practice Address |
2275 W Broadway St Idaho Falls ID 83402-2902 |
| Practice Telephone | 2085247400 |
| Enumeration Date | 2014-08-13 |
| Last Update Date | 2014-08-13 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
10156-818 | ID | Behavioral Health & Social Service Providers |
| Street Address |
2275 W BROADWAY ST |
| City | IDAHO FALLS |
| State | ID |
| Zip Code | 83402-2902 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477766905 | Tueller Counseling Inc | Counselor | 2275 W Broadway St, Suite G, Idaho Falls, ID 83402-2902 | 2007-05-08 |
| 1619585536 | Mary E Hill | Social Worker | 2275 W Broadway St, Idaho Falls, ID 83402-2902 | 2020-07-16 |
| 1417506478 | Marisol Ramirez Angeles | Social Worker | 2275 W Broadway St, Idaho Falls, ID 83402-2902 | 2019-09-11 |
| 1184160970 | Brandi Hobbs | Social Worker | 2275 W Broadway St, Suite G, Idaho Falls, ID 83402-2902 | 2017-01-17 |
| 1316395205 | Erica Lynne Liebe | Social Worker | 2275 W Broadway St, Suite G, Idaho Falls, ID 83402-2902 | 2016-06-01 |
| 1245604743 | Laney Stenquist | Social Worker | 2275 W Broadway St, #g, Idaho Falls, ID 83402-2902 | 2015-11-20 |
| 1447651773 | Cameron Ball | Social Worker | 2275 W Broadway St, Suite G, Idaho Falls, ID 83402-2902 | 2014-09-05 |
| 1215344726 | Charles Alvin Melick IIi | Counselor | 2275 W Broadway St, Ste. G, Idaho Falls, ID 83402-2902 | 2014-07-16 |
| 1306273784 | Mark Barry Bennett | Social Worker | 2275 W Broadway St, Ste G, Idaho Falls, ID 83402-2902 | 2013-10-01 |
| 1992132427 | Tueller Counseling | Clinic/Center | 2275 W Broadway St, Suite G, Idaho Falls, ID 83402-2902 | 2013-09-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326648015 | Abigail Oakley | Counselor | Tueller Counseling Services, 2275 W Broadway Suite G, Idaho Falls, ID 83402 | 2020-10-30 |
| 1265041479 | Fresenius Medical Care Snake River | Clinic/Center | 3195 South Fork Blvd, Idaho Falls, ID 83402 | 2020-07-24 |
| 1295352391 | Fresenius Medical Care Idaho Falls, LLC | Clinic/Center | 3193 South Fork Blvd, Idaho Falls, ID 83402 | 2020-07-06 |
| 1952923765 | Sterling Provider Group | Clinic/Center | 7017 Daisy Lane, Idaho Falls, ID 83402 | 2020-05-14 |
| 1528604188 | Leslie Hendrian | Massage Therapist | 86 N Kaylee Circle, Idaho Falls, ID 83402 | 2019-11-19 |
| 1154966760 | Christine Nicole Cardona | Counselor | 855 N. Captital Ave Ste 1, Idaho Falls, ID 83402 | 2019-11-07 |
| 1750847786 | Brandi S Warnke | Social Worker | 254 E Street, Suite B, Idaho Falls, ID 83402 | 2019-02-14 |
| 1013402809 | Kailey Lynn Moore | Pharmacist | 376 West 18th Street, Idaho Falls, ID 83402 | 2018-06-25 |
| 1407368616 | Jessica Owsley | Social Worker | 2275 W Broadway Ste G, Idaho Falls, ID 83402 | 2017-10-27 |
| 1427419886 | Becky Allen | Developmental Therapist | 150 Shoupe Ave, Idaho Falls, ID 83402 | 2016-03-14 |
| Find all providers in zip 83402 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366099293 | Idaho Recovery Center, LLC. | Counselor | 771 South Woodruff Avenue, Idaho Falls, ID 83401 | 2019-08-26 |
| 1932257524 | Family Recovery Center Foundation | Counselor | 1420 E 17th St, Suite B, Idaho Falls, ID 83404-6283 | 2007-01-08 |
| 1467066183 | James Garner Barnes | Counselor | 2275 W Broadway St Ste G, Idaho Falls, ID 83402-2902 | 2020-09-01 |
| 1134767791 | Adam David Rowbury | Counselor | 1020 Land Bank St, Idaho Falls, ID 83402-1809 | 2019-12-13 |
| 1760032502 | Aspen Consulting and Management Services, LLC | Counselor | 771 South Woodruff Avenue, Idaho Falls, ID 83401 | 2019-09-13 |
| 1538611652 | Willow Sage Services LLC | Counselor | 2475 Mesa St, Idaho Falls, ID 83401-3312 | 2016-10-25 |
| 1598118432 | Lindsee Nail | Counselor | 482 Constitution Way, Idaho Falls, ID 83402-3565 | 2016-07-15 |
| 1861844094 | Edward Mathews | Counselor | 482 Constitution Way, Suite 110, Idaho Falls, ID 83402-3565 | 2016-07-12 |
| 1841668761 | Jerilyn Taylor | Counselor | 615 Hoopes Ave, Idaho Falls, ID 83401-6106 | 2015-09-09 |
| 1013398064 | Steven Orme | Counselor | 545 Shoup Ave, Idaho Falls, ID 83402-3575 | 2015-06-16 |
| Find all providers in IDAHO FALLS | ||||
| City | IDAHO FALLS |
| Zip Code | 83402 |
Please comment or provide details below to improve the information on ANNETTE FULTZ.
| 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.