Active NPI
Lisa Ann Fulmer, LCSW-R
- Clinical Social Worker
- Pittsford, NY
National Provider Identifier
1093086746
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- R035653-1
- Practice address
- 20 Office Park Way
Tobey Village Office Park
Pittsford, NY 14534 - Phone
- (585) 314-9737
- Fax
- (585) 248-6297
- NPI assigned
- Jan 25, 2012
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | R035653-1 | NY | Primary |
Addresses
Primary practice location
20 Office Park Way
Tobey Village Office Park
Pittsford, NY 14534
Mailing address
3108 Clover Street
Pittsford, NY 14534
Phone (585) 314-9737
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20180307000488 | NY | Practitioner - Clinical Social Worker | 8527329630 | Practice locations: Pittsford, NY |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R035653-1 | NY | MD | Clinical Social Worker |
| 035653 | NY | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1327449600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1354752000000",
"number": "1093086746",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3108 CLOVER STREET",
"city": "PITTSFORD",
"state": "NY",
"postal_code": "14534",
"telephone_number": "585-314-9737",
"fax_number": "585-248-6797"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20 OFFICE PARK WAY",
"address_2": "TOBEY VILLAGE OFFICE PARK",
"city": "PITTSFORD",
"state": "NY",
"postal_code": "14534",
"telephone_number": "585-314-9737",
"fax_number": "585-248-6297"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FULMER",
"first_name": "LISA",
"middle_name": "ANN",
"name_prefix": "Ms.",
"credential": "LCSW-R",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-01-25",
"last_updated": "2012-12-06",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NY",
"license": "R035653-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pittsford, NY
- Frederick J Fouquet OD PC & Kevin B Wynne PTRS
- Frederick J Fouquet, OD PC & Kevin B Wynne, OD, PTRS
- Frederick J Fouquet, OD PC & Kevin B Wynne, OD, PTRS
- Richard Walter Freeman, M.D.
- Amy Fromm, RDN
- James Francis Gaffney, DC
- James Michael Gagnier, M.D.
- McKensie Galusha, DPT, PT
- Mary Grace Gambino
- Holly R Garber, M.D.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2012; 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.