Traci L Fulmer, CASAC
Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Dundee, NY
NPI 1891558680 · NPPES record last updated Feb 5, 2024
Key facts
- NPI
- 1891558680
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Addiction (Substance Use Disorder) Counselor 101YA0400X
- License
- 37331 (NY)
- Practice address
- 11 Oakwood Est
Dundee, NY 14837-1154 - Phone
- (315) 640-1472
- NPI assigned
- Feb 5, 2024
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 37331 | NY | MD | Addiction (Substance Use Disorder) Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 37331 | NY | Yes |
Addresses
Primary practice location
11 Oakwood Est
Dundee, NY 14837-1154
Mailing address
11 Oakwood Est
Dundee, NY 14837-1154
Phone (315) 640-1472
Other providers in Dundee, NY
- Gary Michael Demuynck
- Dundee Central School District
- Nicole L Dusenbury
- Dorothy Elizabeth
- Finger Lakes Community Health
- Alice Gilbert
- Melissa J Gilbert
- Mary May Gillette
- Rosemary Hancock
- Madison Carletta Belle Hill
All providers in Dundee, NY · Addiction (Substance Use Disorder) Counselor in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 5, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.