Nicholas Fulks

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

S.1700502 Issued in OH

Practice address

400 Tuscarawas St W
Canton, OH 44702-2044

Phone

(330) 438-2400

Fax

(330) 823-7078

NPI assigned

Feb 26, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Coleman Professional Services, Inc.

  • Mental Health Counselor
  • Kent, OH
  • NPI 1982637633

  Clinical

  Medicare reassignment NPD
• Thrive Counseling LLC

  dba Thriveworks

  • Mental Health Counselor
  • Lynchburg, VA
  • NPI 1215181300

  OH

  Medicare reassignment NPD

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

{
    "created_epoch": "1519603200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519603200000",
    "number": "1053812966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5982 RHODES RD",
            "city": "KENT",
            "state": "OH",
            "postal_code": "442408100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 TUSCARAWAS ST W",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447022044",
            "telephone_number": "330-438-2400",
            "fax_number": "330-823-7078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULKS",
        "first_name": "NICHOLAS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-02-26",
        "last_updated": "2018-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "S.1700502",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelly A. Fryer-Tisevich, P.T.
• Scarlett Rayne Fryer
• Stephanie Fryfogle
• Kristina Fryson, MSW, LISW
• Daniel J Fuline, MSW,ACSW,LISW,DCSW
• Ashlen Elizabeth Fuller
• Nicole C. Fuller, LPCC-S
• Scott R Fuller, DO
• Katrina E Fulmer, CRNA
• Fulton Pharmacy, Inc. (Fulton Drugs)

• Clinical Social Worker in Canton, OH
• Providers in Canton, OH by specialty
• Clinical Social Worker in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.