Shannon Noelle Fulcrod, LCSW, CSAC, MAC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

0904007103 Issued in VA

Practice address

9300 Dewitt Loop
Fort Belvoir, VA 22060-5285

Phone

(571) 231-1200

NPI assigned

Sep 6, 2013

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1378425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730937600000",
    "number": "1003241209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9532 AIRDRIE LN",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224089521",
            "telephone_number": "540-760-8985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9300 DEWITT LOOP",
            "city": "FORT BELVOIR",
            "state": "VA",
            "postal_code": "220605285",
            "telephone_number": "571-231-1200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULCROD",
        "first_name": "SHANNON",
        "middle_name": "NOELLE",
        "name_prefix": "Ms.",
        "credential": "LCSW, CSAC, MAC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-09-06",
        "last_updated": "2024-11-07",
        "certification_date": "2024-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "VA",
            "license": "0710102773",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904007103",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patricia Rose Fritzsche, OB/GYN NP
• Joseph Michael Frontino, DO
• Ft Belvoir Community Hospital
• Ft Belvoir Hospital Outpatient Pharmacy
• Stephanie Roell Fugate, VA
• Angelica Faye Fullerton, MD
• Tyler Fulton
• Daniel Sayre Gabbay, M.D.
• April Barnes Gaines, PHD
• Raymond Charles Gant, D.D.S.

• Clinical Social Worker in Fort Belvoir, VA
• Providers in Fort Belvoir, VA by specialty
• Clinical Social Worker in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.