Elizabeth Fuller, LMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

19212 Issued in AZ

Practice address

1355 S Higley Rd Ste 115
Gilbert, AZ 85296-4789

Phone

(718) 930-1836

NPI assigned

Oct 15, 2021

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)

Not enrolled

State licenses

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

{
    "created_epoch": "1634256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634256000000",
    "number": "1821751900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1456 E GLACIER PL",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852495459",
            "telephone_number": "718-930-1836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1355 S HIGLEY RD STE 115",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852964789",
            "telephone_number": "718-930-1836"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLER",
        "first_name": "ELIZABETH",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-15",
        "last_updated": "2021-10-15",
        "certification_date": "2021-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AZ",
            "license": "19212",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lee Fu, MD
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• Fulcher Dental PLC
• Full Bloom Therapy Az
• Daphne Fuller
• Madison Fuller
• Sarah Fuller
• Michelle Lee Fulp, NP
• William Fowler Fulton Jr., M.D.
• Josalyn Camille Funches, M.D.

• Clinical Social Worker in Gilbert, AZ
• Providers in Gilbert, AZ by specialty
• Clinical Social Worker in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2021; 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.