Lisa Fuller, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

SWB-2024-0077 Issued in NM

Practice address

18 Tierra Monte St NE
Albuquerque, NM 87122-2102

Phone

(505) 249-1669

NPI assigned

Jan 22, 2024

Last updated

Jan 22, 2024By the provider in NPPES

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 NM

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1705881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705881600000",
    "number": "1790546323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 TIERRA MONTE ST NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871222102",
            "telephone_number": "505-249-1669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18 TIERRA MONTE ST NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871222102",
            "telephone_number": "505-249-1669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLER",
        "first_name": "LISA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-01-22",
        "last_updated": "2024-01-22",
        "certification_date": "2024-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NM",
            "license": "SWB-2024-0077",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Full Spectrum Gaht
• Anastazia M Fuller
• Barbara B Fuller, PT
• Frances Fuller, LMSW
• Janell Fuller, MD
• Rowena Fuller, LCSW
• Melissa Lee Fullmer, LMT
• Adam Fulton, CSW
• Pamela Angel Fulton, NP
• Shawn Lee Fultz, M.D., J.D., M.P.H.

• Clinical Social Worker in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Clinical Social Worker in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.