| Eric Fullen, LMSW | |
|
790 Fuller Ave Ne, Grand Rapids, MI 49503-1918 | |
| (616) 336-3909 | |
| Not Available |
| Full Name | Eric Fullen |
|---|---|
| Gender | Male |
| Speciality | Social Worker - Clinical |
| Location | 790 Fuller Ave Ne, Grand Rapids, Michigan |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477105294 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Entity Name | Kent County Cmh Authority |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1588935068 PECOS PAC ID: 9436314143 Enrollment ID: O20120703000167 |
| Mailing Address | Practice Location Address |
|---|---|
| Eric Fullen, LMSW 393 Garden Ave, Holland, MI 49424-9602 Ph: (616) 287-5966 | Eric Fullen, LMSW 790 Fuller Ave Ne, Grand Rapids, MI 49503-1918 Ph: (616) 336-3909 |
Jillian Leigh Murray, L.C.S.W Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 300 68th St Se, Grand Rapids, MI 49548 Phone: 616-455-5000 |
Mrs. Sarah Lynn Bylsma, LMSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1471 Grace St Se, Grand Rapids, MI 49506 Phone: 616-913-2006 Fax: 616-913-2005 |
Michele A. Virva, LMSW Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 75 Sheldon Blvd Se, Suite 100 And 101, Grand Rapids, MI 49503 Phone: 616-391-2420 Fax: 616-391-4425 |
Ashleigh Smith, LMSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 3215 Eagle Crest Dr Ne Ste 100, Grand Rapids, MI 49525 Phone: 616-209-8483 |
Diana Duarte-menendez, LMSW Clinical Social Worker Medicare: May Accept Medicare Assignments Practice Location: 790 Fuller Ave Ne, Grand Rapids, MI 49503 Phone: 616-336-3909 |
Mrs. Rebecca Joy Back, LMSW Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 300 68th St Se, Grand Rapids, MI 49548 Phone: 269-929-7342 |
Taylor Alvesteffer, LLMSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 3300 36th St Se, Grand Rapids, MI 49512 Phone: 616-942-2110 |