Individual provider Active NPI

Matthew Stewart-Fulton, LMSW

  • Clinical Social Worker
  • Ann Arbor, MI
National Provider Identifier
1033685615
Registry record updated Oct 22, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801092269 Issued in MI
Practice address
122 S Main St Ste 200
Ann Arbor, MI 48104-1925
Phone
(734) 945-6210
Fax
(734) 207-5326
NPI assigned
Oct 22, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 6801092269 MI Primary

Addresses

Primary practice location

122 S Main St Ste 200
Ann Arbor, MI 48104-1925

Mailing address

122 S Main St Ste 200
Ann Arbor, MI 48104-1925
Phone (734) 945-6210

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
6801092269MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Mjsfulton Psychotherapy PLLC Clinical Current Accepting new patients

Interoperability endpoints

  • Direct secure messaging: mstewartfulton645799@direct.hfhs.org

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1540166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540166400000",
    "number": "1033685615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "122 S MAIN ST STE 200",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481041925",
            "telephone_number": "734-945-6210",
            "fax_number": "734-207-5326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "122 S MAIN ST STE 200",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481041925",
            "telephone_number": "734-945-6210",
            "fax_number": "734-207-5326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEWART-FULTON",
        "first_name": "MATTHEW",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-10-22",
        "last_updated": "2018-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801092269",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

Verify at the official NPI Registry.