Carolyn Diana Fulcher, LCSW is a medicare enrolled "Social Worker - Clinical" provider in Martin, Tennessee. Her current practice location is
215 Hawks Rd Ste 12, Martin, Tennessee. You can reach out to her office (for appointments etc.) via phone at
(731) 281-8070.
Carolyn Diana Fulcher is licensed to practice in Tennessee (license number 6193) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1033407218.
Healthcare Provider's Profile
| Full Name | Carolyn Diana Fulcher |
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| Gender | Female |
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| Speciality | Social Worker - Clinical |
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| Location | 215 Hawks Rd Ste 12, Martin, Tennessee |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1033407218
- Provider Enumeration Date: 07/21/2011
- Last Update Date: 08/23/2024
Medicare PECOS Information:
- PECOS PAC ID: 0042523284
- Enrollment ID: I20150717000586
Medical Identifiers
Medical identifiers for Carolyn Diana Fulcher such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1033407218 | NPI | - | NPPES |
| Q015002 | Medicaid | TN | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 1041C0700X | Social Worker - Clinical | 6193 (Tennessee) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Carolyn Diana Fulcher allows following entities to bill medicare on her behalf.
| Entity Name | Christian Family Medicine, Inc. |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1043252620
PECOS PAC ID: 7315903978
Enrollment ID: O20041206000331 |
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| Entity Name | Seeds Of Hope Counseling, Pllc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1831662832
PECOS PAC ID: 4385984731
Enrollment ID: O20190321000086 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Carolyn Diana Fulcher is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Carolyn Diana Fulcher, LCSW
212 Hawks Road, Suite 12,
Martin, TN 38237-2165
Ph: (731) 281-8070 | Carolyn Diana Fulcher, LCSW
215 Hawks Rd Ste 12,
Martin, TN 38237-2749
Ph: (731) 281-8070 |
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