Active NPI
Leslie Ann Fulp, LICSWA
- Clinical Social Worker
- Centralia, WA
National Provider Identifier
1649143181
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- SWIA.SC.70012264
- Practice address
- 713 Ham Hill Rd
Centralia, WA 98531-5219 - Phone
- (828) 775-3939
- NPI assigned
- Sep 29, 2025
- Sex
- Female
- Sole proprietor
- No
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 | SWIA.SC.70012264 | WA | Primary |
Addresses
Primary practice location
713 Ham Hill Rd
Centralia, WA 98531-5219
Mailing address
713 Ham Hill Rd
Centralia, WA 98531-5219
Phone (828) 775-3939
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SWIA.SC.70012264 | WA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1759104000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1759104000000",
"number": "1649143181",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "713 HAM HILL RD",
"city": "CENTRALIA",
"state": "WA",
"postal_code": "985315219",
"telephone_number": "828-775-3939"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "713 HAM HILL RD",
"city": "CENTRALIA",
"state": "WA",
"postal_code": "985315219",
"telephone_number": "828-775-3939"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FULP",
"first_name": "LESLIE",
"middle_name": "ANN",
"credential": "LICSWA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-09-29",
"last_updated": "2025-09-29",
"certification_date": "2025-09-29",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "WA",
"license": "SWIA.SC.70012264",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Centralia, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.