Individual provider Active NPI

Courtney Darnell Fullwood, LMSW

  • Social Worker
  • Columbia, MD
National Provider Identifier
1386511335
Registry record updated Oct 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
33382 Issued in MD
Practice address
10705 Charter Dr Ste 430
Columbia, MD 21044-2870
Phone
(301) 259-3574
NPI assigned
Oct 22, 2025
Last updated
Oct 22, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 33382 MD Primary

Addresses

Primary practice location

10705 Charter Dr Ste 430
Columbia, MD 21044-2870

Mailing address

10106 Madronawood Dr
Laurel, MD 20708-3164
Phone (240) 855-5032

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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

Enrollment IDStateProvider typePAC IDDetails
I20260110000014 MD Practitioner - Clinical Social Worker 9234615139 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

10106 Madronawood Dr
Laurel, MD 20708-3164

10705 Charter Dr
Suite 430
Columbia, MD 21044-2881

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
33382MDMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
One Heart Health and Wellness CurrentSince Dec 9, 2025 Accepting new patients

Locations

10705 Charter Dr
Ste 430
Columbia, MD 21044
Phone (301) 259-3574

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1761091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761091200000",
    "number": "1386511335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10106 MADRONAWOOD DR",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207083164",
            "telephone_number": "240-855-5032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10705 CHARTER DR STE 430",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210442870",
            "telephone_number": "301-259-3574"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLWOOD",
        "first_name": "COURTNEY",
        "middle_name": "DARNELL",
        "name_prefix": "Mr.",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-10-22",
        "last_updated": "2025-10-22",
        "certification_date": "2025-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MD",
            "license": "33382",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MD

Sources for this page

Verify at the official NPI Registry.