Individual provider Active NPI

Lavendee M Fulton, LMSW

  • Social Worker
  • Okemos, MI
National Provider Identifier
1760849772
Registry record updated Apr 1, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
6801066385 Issued in MI
Practice address
4660 Marsh Rd
Okemos, MI 48864-2143
Phone
(517) 347-2126
Fax
(517) 347-7892
NPI assigned
Jan 21, 2016
Last updated
Apr 1, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 1, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 6801066385 MI Primary

Addresses

Primary practice location

4660 Marsh Rd
Okemos, MI 48864-2143

Mailing address

4660 Marsh Rd
Okemos, MI 48864-2143
Phone (517) 347-2126

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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

Enrollment IDStateProvider typePAC IDDetails
I20160510000098 MI Practitioner - Clinical Social Worker 0749579035 Reassigns benefits to 1 organization
Practice locations: Okemos, MI

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Therapy Today Counseling and Consulting LLCGroup PAC ID 2567607062, 27 clinicians

Practice addresses (Care Compare)

4572 S Hagadorn Rd
East Lansing, MI 48823-5385
Phone (517) 481-2133

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801066385MIMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Therapy Today Counseling and Consulting, LLC CurrentSince Feb 24, 2020 Accepting new patients
Women's Personal Growth and Psychotherapy Center, PC PastSince Aug 14, 2022 Accepting new patients
Palazzolo Therapy Services LLC Social Worker PastSince May 1, 2023 Accepting new patients

Locations

4572 S Hagadorn Rd
Ste 1C
East Lansing, MI 48823
Phone (517) 481-2133

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1453334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459468800000",
    "number": "1760849772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4660 MARSH RD",
            "city": "OKEMOS",
            "state": "MI",
            "postal_code": "488642143",
            "telephone_number": "517-347-2126",
            "fax_number": "517-347-7892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4660 MARSH RD",
            "city": "OKEMOS",
            "state": "MI",
            "postal_code": "488642143",
            "telephone_number": "517-347-2126",
            "fax_number": "517-347-7892"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULTON",
        "first_name": "LAVENDEE",
        "middle_name": "M",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-01-21",
        "last_updated": "2016-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6801066385",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Okemos, MI

Sources for this page

Verify at the official NPI Registry.