Kathleen Fulks

Primary specialty

Early Intervention Provider AgencyTaxonomy code 252Y00000X

Practice address

210 S Beach St Ste 200
Daytona Beach, FL 32114-4433

Phone

(386) 898-6040

Fax

(386) 256-2320

NPI assigned

Jul 7, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Hope Behavioral Services of Volusia LLC

  • Clinic/Center
  • Daytona Beach, FL
  • NPI 1891317525

  Behavior Technician

  NPD
• Hope Harbor Therapies

  • Speech-Language Pathologist
  • Daytona Beach, FL
  • NPI 1649622358
  NPD

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

{
    "created_epoch": "1688688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758240000000",
    "number": "1952089187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 S BEACH ST STE 200",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321144433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 S BEACH ST STE 200",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321144433",
            "telephone_number": "386-898-6040",
            "fax_number": "386-256-2320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULKS",
        "first_name": "KATHLEEN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-07-07",
        "last_updated": "2025-09-19",
        "certification_date": "2025-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": "FL",
            "license": null,
            "primary": true
        },
        {
            "code": "2355S0801X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Speech-Language Assistant",
            "state": "FL",
            "license": "S17831",
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "FL",
            "license": "RBT-23-28263",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RBT",
            "identifier": "RBT-23-282263",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SLPA",
            "identifier": "S17831",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "118810000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Andrew Fritze, M.D.
• Front Porch Counseling
• Travis Fuchs, M.D.
• Charlotte Fuentes
• Richard Mitchel Fuentes, DPT
• Barbara Fuller
• Christyn Fuller, APRN
• Michael N Fulton, MD
• Kristi Fuson, APN
• Evan Fynes, M.D.

• Early Intervention Provider Agency in Daytona Beach, FL
• Providers in Daytona Beach, FL by specialty
• Early Intervention Provider Agency in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 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.

Verify at the official NPI Registry.