KELLEY FULKERSON (NPI# 1578942140) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578942140 |
| Entity Type | Individual |
| Full Name | KELLEY FULKERSON |
| Credential | LCSW |
| Practice Address |
822 Woodway St Bowling Green KY 42101-2771 |
| Mailing Address |
380 Suwannee Trail St Bowling Green KY 42103-7956 |
| Practice Telephone | 2709015000 |
| Practice Fax Number | 2708425268 |
| Mailing Telephone | 2709015000 |
| Mailing Fax Number | 2708425268 |
| Enumeration Date | 2015-05-28 |
| Last Update Date | 2020-01-12 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
253923 | KY | Behavioral Health & Social Service Providers |
| N | 1041C0700X |
Social Worker Specialization: Clinical |
7327 | KY | Behavioral Health & Social Service Providers |
| Street Address |
822 WOODWAY ST |
| City | BOWLING GREEN |
| State | KY |
| Zip Code | 42101-2771 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144332172 | Frank Snyder | Social Worker | 822 Woodway St, Bowling Green, KY 42101-2771 | 2006-08-31 |
| 1699337535 | Will Strobel | Rehabilitation Counselor | 822 Woodway St, Bowling Green, KY 42101-2771 | 2019-07-01 |
| 1689232555 | Joshua Dean Shaw | Rehabilitation Counselor | 822 Woodway St, Bowling Green, KY 42101-2771 | 2019-06-04 |
| 1184135154 | Laura Fugate | Counselor | 822 Woodway St, Bowling Green, KY 42101-2771 | 2017-10-18 |
| 1649794207 | Austin Stethen | Counselor | 822 Woodway St, Bowling Green, KY 42101-2771 | 2017-07-26 |
| 1306381058 | Anism Thomas | Counselor | 822 Woodway St, Bowling Green, KY 42101-2771 | 2017-01-04 |
| 1730634106 | Karyn Tardif | Peer Specialist | 822 Woodway St, Bowling Green, KY 42101-2771 | 2016-08-16 |
| 1851764872 | Kadey Heidrich | Peer Specialist | 822 Woodway St, Bowling Green, KY 42101-2771 | 2015-11-13 |
| 1942690102 | Karli Rutherford | Community Health Worker | 822 Woodway St, Bowling Green, KY 42101-2771 | 2015-01-27 |
| 1124421367 | Lateisha Benson | Social Worker | 822 Woodway St, Bowling Green, KY 42101-2771 | 2014-10-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922608827 | Heidi Denise Estes | Nurse Practitioner | 651 U.S. 31 W Bypass Ste 106, Bowling Green, KY 42101 | 2020-10-29 |
| 1205476561 | Emily Nell Conner | Pharmacist | 350 West Us 31 Bypass, Bowling Green, KY 42101 | 2020-01-14 |
| 1598304180 | Elizabeth Page Appling | Nurse Practitioner | 1681 Normal Dr., Bowling Green, KY 42101 | 2019-12-30 |
| 1598306227 | Heather Wells | Nurse Practitioner | 427 U.S. 31w Bypass, Bowling Green, KY 42101 | 2019-10-03 |
| 1275182255 | The Kidz Club-pdn, LLC | Nursing Care | 1537 Highway 185, Suite 3, Bowling Green, KY 42101 | 2019-09-11 |
| 1841756525 | Balance Therapeutic Care, Counseling Services LLC | Counselor | 661 A, 31-w Bypass, Bowling Green, KY 42101 | 2019-02-18 |
| 1184104895 | Paige Spear | Specialist | 661 Us 31w Byp Ste C, Bowling Green, KY 42101 | 2018-08-21 |
| 1205364411 | Amanda Katherin Walden | Dentist | 725 A Kenton Street, Bowling Green, KY 42101 | 2017-06-01 |
| 1932632098 | Tj & L Consulting, LLC | In Home Supportive Care | 661 Us 31w By-pass, Suite G, Bowling Green, KY 42101 | 2017-04-06 |
| 1265974117 | Kentucky Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 1473 Kentucky Street, Bowling Green, KY 42101 | 2016-11-09 |
| Find all providers in zip 42101 | ||||
| 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 |
|---|---|---|---|---|
| 1114544368 | Ariel Laverne Lee | Social Worker | 730 Fairview Ave Ste B1, Bowling Green, KY 42101-2365 | 2020-07-02 |
| 1548806441 | Hillary S Bacon | Social Worker | 1711 Ashley Cir Ste 6, Bowling Green, KY 42104-5801 | 2019-11-26 |
| 1306491576 | Jessica Mahaney | Social Worker | 1830 Destiny Ln Ste 112, Bowling Green, KY 42104-1089 | 2019-08-05 |
| 1619430444 | Dava R Wilson | Social Worker | 1143 Fairway St Ste 320, Bowling Green, KY 42103-2452 | 2019-04-09 |
| 1689180820 | Teri Drake | Social Worker | 1234 Ridgewood Dr, Bowling Green, OH 43402-2696 | 2017-12-26 |
| 1538698444 | Trevor Bowen Mead | Social Worker | 1306 Richland Way, Bowling Green, KY 42103-1540 | 2017-06-06 |
| 1689102204 | Johnson Counseling LLC | Social Worker | 996 Wilkinson Trce Ste A9, Bowling Green, KY 42103-3408 | 2017-05-25 |
| 1346696143 | Carolyn Kates-glass, Msw, Lcsw | Social Worker | 1338 Westen St, Bowling Green, KY 42104-3365 | 2016-05-11 |
| 1952765612 | Julie Mccoy | Social Worker | 855 Lovers Ln Ste 107, Bowling Green, KY 42103-7989 | 2016-04-08 |
| 1871967406 | Sarah L Whitledge | Social Worker | 1111 Shive Ln Ste 104, Bowling Green, KY 42103-8051 | 2015-11-19 |
| Find all providers in BOWLING GREEN | ||||
| City | BOWLING GREEN |
| Zip Code | 42101 |
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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.