Individual provider Active NPI

Tracy Ayanna Nalory Fultz, LCSW

  • Clinical Social Worker
  • Woodbury, TN
National Provider Identifier
1902386394
Registry record updated Aug 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6869 Issued in TN
Practice address
6119 Jim Cummings Hwy
Woodbury, TN 37190-5873
Phone
(423) 596-4186
NPI assigned
Aug 15, 2018
Last updated
Aug 25, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 25, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 6869 TN Primary

Addresses

Primary practice location

6119 Jim Cummings Hwy
Woodbury, TN 37190-5873

Mailing address

PO Box 94
Woodbury, TN 37190-0094
Phone (423) 596-4186

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, NC2 enrollments
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.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20190928000120 TN Practitioner - Clinical Social Worker 9638409964 Reassigns benefits to 1 organization
I20240712001003 NC Practitioner - Clinical Social Worker 9638409964 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6869TNMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
New Dawn Psychiatric Services, PLLC CurrentSince Jun 1, 2024 Accepting new patients
Heart Felt Needs Counseling and Caring Center Inc CurrentSince May 30, 2019 Accepting new patients
Betterlives LLC Past Accepting new patients
Anesthesia Services Associates, PLLC PastSince Jun 1, 2024 Accepting new patients

Locations

111 Airport Rd
Kinston, NC 28501
Phone (252) 527-2390

3505 Adkisson Dr NW
Ste 211
Cleveland, TN 37312
Phone (423) 473-6731

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1534291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787616000000",
    "number": "1902386394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 94",
            "city": "WOODBURY",
            "state": "TN",
            "postal_code": "371900094",
            "telephone_number": "423-596-4186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6119 JIM CUMMINGS HWY",
            "city": "WOODBURY",
            "state": "TN",
            "postal_code": "371905873",
            "telephone_number": "423-596-4186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NALORY FULTZ",
        "first_name": "TRACY",
        "middle_name": "AYANNA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-08-15",
        "last_updated": "2026-08-25",
        "certification_date": "2026-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TN",
            "license": "6869",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbury, TN

Sources for this page

Verify at the official NPI Registry.