Teresa Marie Fullan, MSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Practice address

2479 Aloma Ave
Winter Park, FL 32792-2541

Phone

(352) 638-1526

NPI assigned

Feb 15, 2019

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

Other names 1

• Teresa Marie Yates Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1550188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550188800000",
    "number": "1700342664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1607 ORLANDO AVE",
            "city": "LONGWOOD",
            "state": "FL",
            "postal_code": "327506227",
            "telephone_number": "352-638-1526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2479 ALOMA AVE",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327922541",
            "telephone_number": "352-638-1526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLAN",
        "first_name": "TERESA",
        "middle_name": "MARIE",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-15",
        "last_updated": "2019-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TERESA",
            "last_name": "YATES",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Priscila Nicole Fuentes Martinez
• Delfin J Fuentes, M.D.
• Delia E. Fuentes, LCSW
• Full Bloom Speech Therapy LLC
• Full Spine Chiropractic, LLC
• Fuller Chiropractic Offices PA
• Barbara Jo Fuller, MS
• Joseph Edward Fuller, D.C.
• Nicholas Fuller
• Nicole Funchion

• Clinical Social Worker in Winter Park, FL
• Providers in Winter Park, FL by specialty
• Clinical Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2019; 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.