Mr. Jerry L Fuller Jr., LCSW
Social Worker, Clinical in Bloomfield, New Jersey
1801953716- Practice location
- 31 North Ave, Bloomfield, NJ 07003-5516
- Phone
- 973-338-8530
- Fax
- —
- Last updated
- February 2, 2009
Jerry Lee Fuller is a Social Worker, Clinical based in Bloomfield, NJ. Jerry Lee Fuller practices in Bloomfield, NJ and has the professional credentials of LCSW. The NPI Number for Jerry Lee Fuller is 1801953716 and holds a License No. 44SC05222700 (NJ). The current practice location address for Jerry Lee Fuller is 31 North Ave, Bloomfield, NJ 07003-5516 and can be reached out via phone at 973-338-8530.
Provider Profile Details
- NPI Number
- 1801953716
- Provider Name
- Jerry Lee Fuller
- Credential
- LCSW
- Provider Entity Type
- Individual
- Gender
- Male
- Address
- 31 North Ave, Bloomfield, NJ 07003-5516
- Phone Number
- 973-338-8530
- Primary Taxonomy
- Social Worker, Clinical · 1041C0700X
- Sole Proprietor
- No
- Provider Enumeration Date
- January 2, 2007
- Last Update Date
- February 2, 2009
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 31 North Ave
Bloomfield, NJ 07003-5516 - City
- Bloomfield
- State
- New Jersey
- Zip
- 07003-5516
- Phone Number
- 973-338-8530
Provider Business Mailing Address Details
- Address
- 31 North Ave
Bloomfield, NJ 07003-5516 - City
- Bloomfield
- State
- NJ
- Zip
- 07003-5516
- Phone Number
- 973-338-8530
License Information
- License Number
- 44SC05222700
- License State
- NJ
- Taxonomy
- Social Worker, Clinical · 1041C0700X · 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 Mr. Jerry L Fuller Jr., LCSW?
The NPI number of Mr. Jerry L Fuller Jr., LCSW is 1801953716. It was assigned on January 2, 2007 and is currently active in the NPPES registry.
What is the specialty of Mr. Jerry L Fuller Jr., LCSW?
Mr. Jerry L Fuller Jr., LCSW is registered under the primary taxonomy Social Worker, Clinical (code 1041C0700X), licensed in NJ under license number 44SC05222700.
Where does Mr. Jerry L Fuller Jr., LCSW practice?
The practice location is 31 North Ave, Bloomfield, NJ 07003-5516. The office can be reached at 973-338-8530 (phone).
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 1801953716 directly on the NPPES registry website.