Tara Fulton, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C7433 Issued in MS

Practice address

707 Corinne St
Hattiesburg, MS 39401-3854

Phone

(601) 408-6284

NPI assigned

Apr 22, 2015

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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": "1429660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437955200000",
    "number": "1073900544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "707 CORINNE ST",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394013854",
            "telephone_number": "601-408-6284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 CORINNE ST",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394013854",
            "telephone_number": "601-408-6284"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULTON",
        "first_name": "TARA",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-04-22",
        "last_updated": "2015-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MS",
            "license": "C7433",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MMLGN5758X",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• April Vancleve Frierson, FNP
• Jennifer Froman, LCSW
• Brooke Samantha Fryfogle, FNP
• Taylor Davis Fulks, DO
• Helen Melissa Fuller, M.A., RKT
• Fuse Tec Medical
• Gregory Lee Futral, PH.D.
• Grace Gable, DO
• Donald H Gale, M.D.
• Victoria Galima

• Clinical Social Worker in Hattiesburg, MS
• Providers in Hattiesburg, MS by specialty
• Clinical Social Worker in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2015; 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.