Provider Demographics
NPI:1922576735
Name:FULMER, KAREN (MED LCAS)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:FULMER
Suffix:
Gender:F
Credentials:MED LCAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:723 FAIRVIEW RD
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28803-1107
Mailing Address - Country:US
Mailing Address - Phone:828-350-8343
Mailing Address - Fax:
Practice Address - Street 1:723 FAIRVIEW RD
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28803-1107
Practice Address - Country:US
Practice Address - Phone:828-350-8343
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-09
Last Update Date:2020-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC22604101YA0400X
NCLCAS22604101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)