Lisa Kim Fulfor, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

60055 Issued in TX

Practice address

1333 W McDermott Dr
Allen, TX 75013-3090

Phone

(469) 998-1989

NPI assigned

Oct 31, 2018

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 TX

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, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Forest Path Counseling & Wellness Lisa Fulfor PLLC

  • Clinical Social Worker
  • Plano, TX
  • NPI 1417414525
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1540944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540944000000",
    "number": "1649747205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13254 LIME RIDGE DR",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "750330938",
            "telephone_number": "214-316-0924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1333 W MCDERMOTT DR",
            "city": "ALLEN",
            "state": "TX",
            "postal_code": "750133090",
            "telephone_number": "469-998-1989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULFOR",
        "first_name": "LISA",
        "middle_name": "KIM",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-10-31",
        "last_updated": "2018-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "60055",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Frisco Anesthesia Associates PLLC
• Frisco Family Clinic PA
• Frisco FS Enterprises
• Kelly Frye, OTR/L
• Deysy Fuentes
• Function Focus Counseling PLLC
• Jessica Gallant, LPC
• Roxanne Galunza
• Gamma Anesthesia Associates PLLC
• Molly Gammell, APRN-CNP

• Clinical Social Worker in Allen, TX
• Providers in Allen, TX by specialty
• Clinical Social Worker in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2018; 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.