CAROLYN FULGHAM (NPI# 1871965343) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871965343 |
| Entity Type | Individual |
| Full Name | CAROLYN FULGHAM |
| Practice Address |
5471 Dr Martin Luther King Dr Saint Louis MO 63112-4265 |
| Mailing Address |
330 N Gore Ave Saint Louis MO 63119-1600 |
| Practice Telephone | 3143675820 |
| Mailing Telephone | 3149682060 |
| Enumeration Date | 2015-10-23 |
| Last Update Date | 2020-11-03 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 104100000X | Social Worker | 2015029538 | MO | Behavioral Health & Social Service Providers |
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
2020021039 | MO | Behavioral Health & Social Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 330 N Gore Ave, Saint Louis, MO 631191600 | 3149682060 |
| Street Address |
5471 DR MARTIN LUTHER KING DR |
| City | SAINT LOUIS |
| State | MO |
| Zip Code | 63112-4265 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043825391 | Tiffany Shonta Klopner | Licensed Practical Nurse | 5471 Dr Martin Luther King Dr, Saint Louis, MO 63112-4265 | 2020-09-14 |
| 1396359022 | Pamela Yvonne Wallace | Registered Nurse | 5471 Dr Martin Luther King Dr, Saint Louis, MO 63112-4265 | 2020-09-01 |
| 1548874290 | Ashley D Whitley | Licensed Practical Nurse | 5471 Dr Martin Luther King Dr, Saint Louis, MO 63112-4265 | 2020-09-01 |
| 1184235616 | Kendra Nailah Hughes | Licensed Practical Nurse | 5471 Dr Martin Luther King Dr, Saint Louis, MO 63112-4265 | 2020-08-10 |
| 1780202135 | Amy Marie Heidotten | Registered Nurse | 5471 Dr Martin Luther King Dr, Saint Louis, MO 63112-4265 | 2020-07-13 |
| 1376161729 | Monica Jeanne Witherspoon | Registered Nurse | 5471 Dr Martin Luther King Dr, Saint Louis, MO 63112-4265 | 2020-07-13 |
| 1629691233 | Lavada Dolores James | Dental Hygienist | 5471 Dr Martin Luther King Dr, Saint Louis, MO 63112-4265 | 2020-05-19 |
| 1851910277 | Raven Clay | Nurse's Aide | 5471 Dr Martin Luther King Dr, Saint Louis, MO 63112-4265 | 2020-04-15 |
| 1093342800 | Brittany Xia Wright | Licensed Practical Nurse | 5471 Dr Martin Luther King Dr, Saint Louis, MO 63112-4265 | 2020-03-24 |
| 1124652714 | Jaemi Madlambayan Tiongson | Registered Nurse | 5471 Dr Martin Luther King Dr, Saint Louis, MO 63112-4265 | 2020-02-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851932990 | Bobbie J. Harrington | Technician | 5626 Julian Avenue, St. Louis, MO 63112 | 2019-09-30 |
| 1861901480 | Christina Cummings | Counselor | 5387 Pershing Ave., Apt. A, St. Louis, MO 63112 | 2017-09-26 |
| 1326457177 | Clare Marie Salley | Speech-Language Pathologist | 5673 Waterman Blvd, Unit 31, St Louis, MO 63112 | 2014-08-06 |
| 1386999324 | Family Love Adult Health Care Center, LLC | Clinic/Center | 286 Debaliviere Avenue, St. Louis, MO 63112 | 2012-07-16 |
| 1003133893 | William Richard Humphrey II | Chiropractor | 5615 Pershing, Suite 22, St. Louis, MO 63112 | 2010-05-03 |
| 1558688408 | Courtney Lynne Luster | Counselor | 5647 Delmar Blvd Ste 226, Saint Louis, MO 63112 | 2010-04-30 |
| 1134446602 | Donald Trevor Cross | Psychologist | #7 Beverly Place, St. Louis, MO 63112 | 2010-04-23 |
| 1649507328 | Vikram Choudhary | Prosthetist | 6126 Washington Blvd, # 201, St. Louis, MO 63112 | 2009-11-17 |
| 1992930325 | Kelly Brook Hogan | Social Worker | 5355 Delmar, Saint Louis, MO 63112 | 2009-05-29 |
| 1942449194 | Annie Malone Children and Family Service Center | Respite Care | 5355 Page Avenue, St. Louis, MO 63112 | 2009-02-11 |
| Find all providers in zip 63112 | ||||
| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| A social worker who holds a master’s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master’s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. |
| Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760097182 | Laura Ranalletta | Social Worker | 877 Queen Anne Pl, Saint Louis, MO 63122-3143 | 2020-09-11 |
| 1861007502 | Helene Foster Platke | Social Worker | 11681 Summerhaven Dr, Saint Louis, MO 63146-5441 | 2020-09-10 |
| 1063027811 | Elizabeth Stonefield | Social Worker | 8188 Middlevalley Trl, Saint Louis, MO 63123-2415 | 2020-09-09 |
| 1770195729 | Kyla Hadenfeldt | Social Worker | 4562a Loughborough Ave, Saint Louis, MO 63116-1131 | 2020-08-20 |
| 1093327587 | Lori B Goldenberg | Social Worker | 3 Winfield Pointe Ln, Saint Louis, MO 63141-7710 | 2020-08-18 |
| 1831701473 | Michael David Galvin | Social Worker | 3425 Humphrey St, Saint Louis, MO 63118-2720 | 2020-08-17 |
| 1265043376 | Matt Fanning | Social Worker | 9378 Olive Blvd Ste 205, Saint Louis, MO 63132-3223 | 2020-08-12 |
| 1235748765 | Celia Rose Mcmanus | Social Worker | 10004 Kennerly Rd Ste 280b, Saint Louis, MO 63128-2177 | 2020-07-30 |
| 1841809019 | Danielle Denise Collins | Social Worker | 12360 Creek Run Dr Apt M, Saint Louis, MO 63141-6579 | 2020-07-23 |
| 1730797176 | Jill Louise Medintz | Social Worker | 130 S Bemiston Ave Ste 704a, Saint Louis, MO 63105-1913 | 2020-07-22 |
| Find all providers in SAINT LOUIS | ||||
| City | SAINT LOUIS |
| Zip Code | 63112 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.