Theresa K Fullhart, MSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

05866 Issued in IA

Practice address

905 Montgomery Street
Decorah, IA 52101

Phone

(563) 382-3649

Fax

(563) 382-8183

NPI assigned

May 10, 2006

Last updated

Aug 18, 2010By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Abbe Management Corp

  dba Associates for Behavioral Health

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Hiawatha, IA
  • NPI 1811998859
  NPD (past)
• Northeast Iowa Mental Health Center

  dba Northeast Iowa Behavioral Health, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Decorah, IA
  • NPI 1710933445
  NPD (past)
• United Community Services, Inc.

  • Point of Service
  • West Des Moines, IA
  • NPI 1609998137
  NPD (past)

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

{
    "created_epoch": "1147219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1282089600000",
    "number": "1780634196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "905 MONTGOMERY ST",
            "city": "DECORAH",
            "state": "IA",
            "postal_code": "521012325",
            "telephone_number": "563-382-3649",
            "fax_number": "563-382-8183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "905 MONTGOMERY STREET",
            "city": "DECORAH",
            "state": "IA",
            "postal_code": "52101",
            "telephone_number": "563-382-3649",
            "fax_number": "563-382-8183"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLHART",
        "first_name": "THERESA",
        "middle_name": "K",
        "name_prefix": "Ms.",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-10",
        "last_updated": "2010-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IA",
            "license": "05866",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Timothy Duane Fechner, DPT
• Breanne Marie Fillman
• Cheryl Leann Flatin, D.C.
• Andrew W Fritz, ATC, LAT
• Hannah Frye, CFY-SLP
• Stephanie Grusy Garcia-Prats, LMSW
• Hannah Gaveske, ATC
• David Geenen, TCADC
• David Joseph Gehling, D.C.
• Tedd W Gentry, M.D.

• Clinical Social Worker in Decorah, IA
• Providers in Decorah, IA by specialty
• Clinical Social Worker in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2010; 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.