Michael Nicholas Fulco, PHD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

06958 Issued in NY

Practice address

1155 New Britain Ave
West Hartford, CT 06110-2486

Phone

(860) 523-0855

Fax

(860) 586-8782

NPI assigned

Dec 11, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Nov 13, 2017 through Nov 13, 2027

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1881754836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1155 NEW BRITAIN AVE",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "061102486",
            "telephone_number": "860-523-0855",
            "fax_number": "860-586-8782"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1155 NEW BRITAIN AVE",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "061102486",
            "telephone_number": "860-523-0855",
            "fax_number": "860-586-8782"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULCO",
        "first_name": "MICHAEL",
        "middle_name": "NICHOLAS",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-11",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "CT",
            "license": "00992",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "06958",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CT",
            "license": "00992",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ian William Thomson Friedrich, LCSW
• Kevin Froese, DPT
• Christopher Frombach, OTR/L
• Thomas Newman Fromson, M.D.
• Yolanda P Frontera, DDS, MDS
• Full Stack Psychology
• Kirsten Gaddis, OTR/L
• Jacob Marshall Gady, D.M.D., M.D.
• Kaitlyn A. Gagne, M.A., CCC-SLP
• Michael Moses Gale, PH.D.

• Psychologist in West Hartford, CT
• Providers in West Hartford, CT by specialty
• Psychologist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.