Kelley Fulkerson, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

253923 Issued in KY

Practice address

2817 Veach Rd
Owensboro, KY 42303-6252

Phone

(270) 240-5312

Fax

(270) 495-4305

NPI assigned

May 28, 2015

Last updated

Sep 8, 2026By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in KY, OH2 enrollments

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 2

Specialty

Clinical Social Worker

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lifesource of North CarolinaGroup PAC ID 7416132428, shared by 9 NPIs, 172 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kelleyfulkerson@tdh.allscriptsdirect.net

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.

• Lifesource of North Carolina

  • Clinical Social Worker
  • Pikeville, KY
  • NPI 1538728183
  Medicare reassignment NPD
• Lifesource of North Carolina

  • Clinical Social Worker
  • Holland, OH
  • NPI 1619515277
  Medicare reassignment NPD
• Kelley Fulkerson Counseling, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Owensboro, KY
  • NPI 1487427894
  Authorized official Same address or phone
• Lifesource of North Carolina

  • Psychologist
  • Milton, FL
  • NPI 1730648288

  Clinical

  NPD
• Teladoc Health Medical Group, P.a.

  • Family Medicine Physician
  • Lewisville, TX
  • NPI 1245403567

  Clinical

  NPD

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

{
    "created_epoch": "1432771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788825600000",
    "number": "1578942140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2817 VEACH RD",
            "city": "OWENSBORO",
            "state": "KY",
            "postal_code": "423036252",
            "telephone_number": "270-832-4945",
            "fax_number": "270-495-4305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2817 VEACH RD",
            "city": "OWENSBORO",
            "state": "KY",
            "postal_code": "423036252",
            "telephone_number": "270-240-5312",
            "fax_number": "270-495-4305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULKERSON",
        "first_name": "KELLEY",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-05-28",
        "last_updated": "2026-09-08",
        "certification_date": "2026-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KY",
            "license": "253923",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Freedom Healthcare, LLC (Freedom Healthcare)
• Freedom Wellness Center
• Joshua Andrew Frey, PHARM. D.
• Vicki L Frey, D.M.D.
• Laura M Fritz, LCSW
• Megan Marie Fulkerson, APRN
• Michael Hugh Fulkerson, MAE, LPCC
• Shana Fulkerson, CSW
• Allie Shea Fuller
• Haley Marie Fuller, APRN

• Clinical Social Worker in Owensboro, KY
• Providers in Owensboro, KY by specialty
• Clinical Social Worker in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2026; 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.