MR. DERRICK CORNELIUS FULLWOOD
NPI 1154656338
Community/Behavioral Health in Clinton, NC

Q: What is Derrick Fullwood's NPI number?

The NPI number for Derrick Fullwood is 1154656338. It was assigned to this individual provider in the NPPES registry on October 6, 2009.

Q: What is Derrick Fullwood's specialty?

The primary specialty registered for this NPI is Community/Behavioral Health with taxonomy code 251S00000X.

Q: When was this NPI record last updated?

The NPPES record for Derrick Fullwood was last updated on October 6, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since October 06, 2009

4442 BONNETSVILLE RD, CLINTON, NC 28328(919) 673-6332 Get Directions Write a Review

NPPES record last updated: October 6, 2009. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Mr. Derrick Cornelius Fullwood NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. DERRICK CORNELIUS FULLWOOD (NPI 1154656338) is an individual community/behavioral health provider in Clinton, North Carolina and active in the NPI registry since October 2009.

NPPES Registry Identity

NPI1154656338

Entity TypeIndividualMale

Primary Taxonomy251S00000X

Provider Legal NameMR. DERRICK CORNELIUS FULLWOOD

Location Address4442 BONNETSVILLE RDClinton, NC 28328-1001

Mailing Address4337 Lake Ridge DrRaleigh, NC 27604-3469 · (919) 673-6332

Phone(919) 673-6332

Sole ProprietorYes

Enumeration DateOctober 6, 2009

✔ NPI 1154656338 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCommunity/Behavioral HealthAgencies

Taxonomy Code251S00000X

Definition

A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment.

4442 BONNETSVILLE RD, Clinton, NC 28328

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Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Derrick Fullwood's NPI number?

The NPI number for Derrick Fullwood is 1154656338. It was assigned to this individual provider in the NPPES registry on October 6, 2009.

Where is Derrick Fullwood located?

Derrick Fullwood practices at 4442 Bonnetsville Rd, Clinton, NC 28328. The listed phone number is (919) 673-6332.

What is Derrick Fullwood's specialty?

The primary specialty registered for this NPI is Community/Behavioral Health with taxonomy code 251S00000X.

When was this NPI record last updated?

The NPPES record for Derrick Fullwood was last updated on October 6, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.