Katelin Fullerton, LCSW-C

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

25421 Issued in MD

Practice address

822 Guilford Ave
Baltimore, MD 21202-3707

Phone

(410) 671-5774

NPI assigned

Nov 13, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Katelin Fullerton Psychotherapy, LLC

  • Clinical Social Worker
  • Baltimore, MD
  • NPI 1528716230
  NPD Authorized official

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

{
    "created_epoch": "1573603200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664841600000",
    "number": "1861037871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "822 GUILFORD AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212023707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "822 GUILFORD AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212023707",
            "telephone_number": "410-671-5774"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 W Church St",
            "address_purpose": "LOCATION",
            "city": "Frederick",
            "state": "MD",
            "postal_code": "217015991",
            "country_code": "US",
            "telephone_number": "301-360-4349 x103",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FULLERTON",
        "first_name": "KATELIN",
        "credential": "LCSW-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-13",
        "last_updated": "2022-10-04",
        "certification_date": "2022-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MD",
            "license": "25421",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "25421",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Benjamin Fuller
• Donald Jenkins Fuller, PA-C
• Jacqueline L Fuller
• Lonnie Edward Fuller Jr., MD
• Robert Fuller, MD
• Joshua Fullwood
• Kennedi Kirsten Fullwood
• Michael Alain Fulop, M.D.
• Anaya Fulton
• Carlyn Fulton, PA-C

• Clinical Social Worker in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Clinical Social Worker in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2022; 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.