Timothy Fuller, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LC21772 Issued in ME

Practice address

844 Stevens Ave
Portland, ME 04103-2676

Phone

(207) 505-0227

NPI assigned

Jan 9, 2020

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 ME

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

Specialty

Clinical Social Worker

Education

Other, 2018

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

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.

• Chaos and Compassion LLC

  • Clinical Social Worker
  • Portland, ME
  • NPI 1689538894
  Medicare reassignment NPD Authorized official
• Counseling and Trauma Therapy Associates

  • Clinical Social Worker
  • Biddeford, ME
  • NPI 1396264933
  NPD (past)

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

{
    "created_epoch": "1578528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765843200000",
    "number": "1114567807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "844 STEVENS AVE",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041032676",
            "telephone_number": "207-505-0227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "844 STEVENS AVE",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041032676",
            "telephone_number": "207-505-0227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLER",
        "first_name": "TIMOTHY",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-01-09",
        "last_updated": "2025-12-16",
        "certification_date": "2025-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ME",
            "license": "LC21772",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Debra A Fuchs Ertman, MD
• Stepfany Fuentes, DO
• Heidi Marie Fuller, CRNA
• Joann Fuller
• Melissa Fuller
• Valerie J Fuller, RN, FNP-C
• David Fulmer, CRNA
• Angus Fung, DO
• Maureen Furlong, CRNA
• Nick John Furlong, MD

• Clinical Social Worker in Portland, ME
• Providers in Portland, ME by specialty
• Clinical Social Worker in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2025; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.