Dr. Constance Fullwood, PHNL, PMHNP-BC
Nurse Practitioner, Psych/Mental Health in Long Island City, New York
1134798663- Practice location
- 36-11 21ST St, Long Island City, NY 11106-4505
- Phone
- 718-482-7772
- Fax
- 718-482-9648
- Last updated
- August 5, 2026
Constance Fullwood is a Nurse Practitioner, Psych/Mental Health based in Long Island City, NY. Constance Fullwood practices in Long Island City, NY and has the professional credentials of PHNL, PMHNP-BC. The NPI Number for Constance Fullwood is 1134798663 and holds a License No. RN250856 (MA). The current practice location address for Constance Fullwood is 36-11 21ST St, Long Island City, NY 11106-4505 and can be reached out via phone at 718-482-7772 and via fax at 718-482-9648.
Provider Profile Details
- NPI Number
- 1134798663
- Provider Name
- Constance Fullwood
- Credential
- PHNL, PMHNP-BC
- Provider Entity Type
- Individual
- Gender
- Female
- Address
- 36-11 21ST St, Long Island City, NY 11106-4505
- Phone Number
- 718-482-7772
- Fax Number
- 718-482-9648
- Primary Taxonomy
- Nurse Practitioner, Psych/Mental Health · 363LP0808X
- Sole Proprietor
- Yes
- Provider Enumeration Date
- June 19, 2021
- Last Update Date
- August 5, 2026
- Certification Date
- August 5, 2026
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 36-11 21ST St
Long Island City, NY 11106-4505 - City
- Long Island City
- State
- New York
- Zip
- 11106-4505
- Phone Number
- 718-482-7772
- Fax Number
- 718-482-9648
Provider Business Mailing Address Details
- Address
- 1125 West St # 401
Annapolis, MD 21401-4198 - City
- Annapolis
- State
- MD
- Zip
- 21401-4198
- Phone Number
- 410-934-3494
- Fax Number
- 410-630-7905
License Information
- License Number (1)
- RN250856
- License State (1)
- MA
- Taxonomy (1)
- Nurse Practitioner, Psych/Mental Health · 363LP0808X
- License Number (2)
- F405449-01
- License State (2)
- NY
- Taxonomy (2)
- Nurse Practitioner, Psych/Mental Health · 363LP0808X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
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Frequently Asked Questions
What is the NPI number of Dr. Constance Fullwood, PHNL, PMHNP-BC?
The NPI number of Dr. Constance Fullwood, PHNL, PMHNP-BC is 1134798663. It was assigned on June 19, 2021 and is currently active in the NPPES registry.
What is the specialty of Dr. Constance Fullwood, PHNL, PMHNP-BC?
Dr. Constance Fullwood, PHNL, PMHNP-BC is registered under the primary taxonomy Nurse Practitioner, Psych/Mental Health (code 363LP0808X), licensed in MA under license number RN250856.
Where does Dr. Constance Fullwood, PHNL, PMHNP-BC practice?
The practice location is 36-11 21ST St, Long Island City, NY 11106-4505. The office can be reached at 718-482-7772 (phone) or 718-482-9648 (fax).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1134798663 directly on the NPPES registry website.