Active NPI
Carl Fuller Jr., LMSW
- Social Worker
- Tulsa, OK
National Provider Identifier
1871386961
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 20646
- Practice address
- 1869 E 17TH St
Tulsa, OK 74104-5304 - Phone
- (405) 549-4356
- NPI assigned
- May 22, 2025
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 20646 | OK | Primary |
Addresses
Primary practice location
1869 E 17TH St
Tulsa, OK 74104-5304
Mailing address
1869 E 17TH St
Tulsa, OK 74104-5304
Phone (405) 549-4356
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20646 | OK | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1747872000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1747872000000",
"number": "1871386961",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1869 E 17TH ST",
"city": "TULSA",
"state": "OK",
"postal_code": "741045304",
"telephone_number": "405-549-4356"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1869 E 17TH ST",
"city": "TULSA",
"state": "OK",
"postal_code": "741045304",
"telephone_number": "405-549-4356"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FULLER",
"first_name": "CARL",
"name_prefix": "Mr.",
"name_suffix": "Jr.",
"credential": "LMSW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2025-05-22",
"last_updated": "2025-05-22",
"certification_date": "2025-05-22",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "OK",
"license": "20646",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tulsa, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.