Kelcie Denea Fuller

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Practice address

8915 Harry Hines Blvd
Dallas, TX 75235-1717

Phone

(972) 921-4662

NPI assigned

Jul 17, 2017

Last updated

Jul 17, 2017By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1500249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1500249600000",
    "number": "1952824443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 BROWN ST APT 201",
            "city": "WAXAHACHIE",
            "state": "TX",
            "postal_code": "751655106",
            "telephone_number": "972-921-4662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8915 HARRY HINES BLVD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752351717",
            "telephone_number": "972-921-4662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLER",
        "first_name": "KELCIE",
        "middle_name": "DENEA",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-17",
        "last_updated": "2017-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elise Fuller, COTA
• Elise J Fuller, MA, LPC
• Grant Fuller, OTA
• Jeffrey Fuller
• Julie Marie Fuller, MD
• Lakeshia Rena Fuller, RN
• Lauren Caroline Fuller
• Michelle L Fuller, NPC
• Natasha Lachine Fuller, MBA, QMHP-CS, PSS
• Stephanie Renee Fuller, MS, FNP-C

• Clinical Social Worker in Dallas, TX
• Providers in Dallas, TX by specialty
• Clinical Social Worker in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2017; 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.