| Denna Fulton Lcsw Llc | |
|
345 W 13th Ave Rm 2 Eugene OR 97401-3483 | |
| (541) 632-4800 | |
| (541) 632-4810 |
| Full Name | Denna Fulton Lcsw Llc |
|---|---|
| Speciality | Social Worker |
| Location | 345 W 13th Ave Rm 2, Eugene, Oregon |
| Authorized Official Name and Position | Denna Marie Fulton (OWNER/THERAPIST) |
| Authorized Official Contact | 5416324800 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Denna Fulton Lcsw Llc 923 E 36th Ave Eugene OR 97405-4352 Ph: (541) 232-3555 | Denna Fulton Lcsw Llc 345 W 13th Ave Rm 2 Eugene OR 97401-3483 Ph: (541) 632-4800 |
| NPI Number | 1699234286 |
|---|---|
| Provider Enumeration Date | 03/14/2019 |
| Last Update Date | 02/03/2020 |
| Certification Date | 02/03/2020 |
| Medicare PECOS PAC ID | 8123356615 |
|---|---|
| Medicare Enrollment ID | O20190821004018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699234286 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Denna Marie Fulton |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1235464504 PECOS PAC ID: 2365777042 Enrollment ID: I20190717003153 |
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