Lisa Marie Fulton, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

24549 Issued in MN

Practice address

8640 Eagle Creek Cir
Savage, MN 55378-4400

Phone

(952) 746-7664

Fax

(952) 224-4867

NPI assigned

Feb 8, 2016

Last updated

Aug 11, 2016By the provider in NPPES

Sex

Female

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1454889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470873600000",
    "number": "1568820397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8640 EAGLE CREEK CIR",
            "city": "SAVAGE",
            "state": "MN",
            "postal_code": "553784400",
            "telephone_number": "952-746-7664",
            "fax_number": "952-224-4867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8640 EAGLE CREEK CIR",
            "city": "SAVAGE",
            "state": "MN",
            "postal_code": "553784400",
            "telephone_number": "952-746-7664",
            "fax_number": "952-224-4867"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULTON",
        "first_name": "LISA",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-02-08",
        "last_updated": "2016-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "24549",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paul James Fleming, O.D.
• Trevor James Flick, MA
• Ann Forshay
• Uche Franklin, DNP, APRN, CNP, FNP
• Ruth Froese, OTR
• Margaret Gardner, LPCC
• Abdiaziz Gedi
• Cathleen J. Gempeler, MT-BC
• Girma a Dufera and Edoshe B Gari
• Golden Heart Senior Care

• Clinical Social Worker in Savage, MN
• Providers in Savage, MN by specialty
• Clinical Social Worker in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2016; 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.