| Kit Fuller, Lmsw, Llc | |
|
2890 Carpenter Rd Ste 1500 Ann Arbor MI 48108-1196 | |
| (734) 255-3342 | |
| (844) 364-8448 |
| Full Name | Kit Fuller, Lmsw, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 2890 Carpenter Rd Ste 1500, Ann Arbor, Michigan |
| Authorized Official Name and Position | Katherine Fuller (OWNER) |
| Authorized Official Contact | 7342553342 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kit Fuller, Lmsw, Llc 2890 Carpenter Rd Ste 1500 Ann Arbor MI 48108-1196 Ph: (734) 255-3342 | Kit Fuller, Lmsw, Llc 2890 Carpenter Rd Ste 1500 Ann Arbor MI 48108-1196 Ph: (734) 255-3342 |
| NPI Number | 1700305687 |
|---|---|
| Provider Enumeration Date | 09/12/2017 |
| Last Update Date | 06/23/2023 |
| Certification Date | 06/23/2023 |
| Medicare PECOS PAC ID | 7517232887 |
|---|---|
| Medicare Enrollment ID | O20171012001946 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700305687 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 6801089969 (Michigan) | Primary |
| Provider Name | Katherine A Fuller |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1407068281 PECOS PAC ID: 9739333949 Enrollment ID: I20130215000278 |
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