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ERIC FULLEN LMSW
NPI 1477105294
Social Worker - Clinical in Grand Rapids, MI

Active since July 11, 2019PECOS Enrolled
790 FULLER AVE NE, GRAND RAPIDS, MI 49503(616) 336-3909 Get Directions Write a Review

NPPES record last updated: March 10, 2026. Verified against the NPPES registry weekly; last sync: November 08, 2026.

Record update history: Mar 10, 2026, Oct 11, 2024, May 5, 2023 and 1 more (4 updates tracked since 2019).

About Eric Fullen Lmsw NPPES

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

ERIC FULLEN LMSW (NPI 1477105294) is an individual clinical provider in Grand Rapids, Michigan and active in the NPI registry since July 2019. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1477105294
Entity TypeIndividualMale
Primary Taxonomy1041C0700X
Provider Legal NameERIC FULLENCredential: LMSW
Location Address790 FULLER AVE NEGrand Rapids, MI 49503-1918
Mailing Address393 Garden AveHolland, MI 49424-9602 · (616) 287-5966
Phone(616) 336-3909
Sole ProprietorNo
Enumeration DateJuly 11, 2019
Last NPPES UpdateMarch 10, 20264 updates tracked since enumeration
NPPES CertifiedMarch 10, 2026
✔ NPI 1477105294 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
Definition
A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
790 FULLER AVE NE, Grand Rapids, MI 49503
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company, Priority Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Eric Fullen Lmsw is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Eric Fullen reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Kent County Cmh Authority
0.1 mi
Community/Behavioral Health
790 FULLER AVE NE
Grand Rapids, MI 49503
  • Reassigned Medicare billing, Michigan enrollment
  • 164 clinicians in this Medicare group
NPI 1396404588 (616) 336-3909

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 49503 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$0.00 typical visit price
range $54.34 – $166.68
Typical copayment $0.00 (range $13.58 – $41.67)
Most-billed visit code NA
Established Patient
$68.07 typical visit price
range $17.09 – $135.40
Typical copayment $17.01 (range $4.27 – $33.85)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DIANA DUARTE-MENENDEZ LMSW
Social Worker (Clinical)
790 FULLER AVE NE
GRAND RAPIDS, MI 49503
Kent County (616) 336-3909
MISS JALISA SHAWTAE SMITH LLMSW
Case Manager/Care Coordinator
790 FULLER AVE NE
GRAND RAPIDS, MI 49503
Kent County (616) 336-3909
MACKENZIE ERIN CLEGG
Behavior Analyst
790 FULLER AVE NE
GRAND RAPIDS, MI 49503
Kent County (616) 336-3909
MRS. ALEITA A BROWN LLBSW
Case Manager/Care Coordinator
790 FULLER AVE NE
GRAND RAPIDS, MI 49503
Kent County (616) 825-5412
ANNIKA KNOTT LMSW
Social Worker (Clinical)
790 FULLER AVE NE
GRAND RAPIDS, MI 49503
Kent County (616) 724-6942
VIOLET RAMAGE
Case Manager/Care Coordinator
790 FULLER AVE NE
GRAND RAPIDS, MI 49503
Kent County (734) 493-2978
DAVID G MARSHALL LPC
Counselor (Professional)
790 FULLER AVE NE
GRAND RAPIDS, MI 49503
Kent County (616) 336-3909
DAWN MARIE MACDONALD LLMSW
Social Worker
790 FULLER AVE NE
GRAND RAPIDS, MI 49503
Kent County (616) 336-3909

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 Eric Fullen's NPI number?

The NPI number for Eric Fullen is 1477105294. It was assigned to this individual provider in the NPPES registry on July 11, 2019.

Where is Eric Fullen located?

Eric Fullen practices at 790 Fuller Ave NE, Grand Rapids, MI 49503. The listed phone number is (616) 336-3909.

What is Eric Fullen's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Is Eric Fullen enrolled in Medicare?

Yes. Eric Fullen is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Eric Fullen's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Eric Fullen reassigns Medicare benefits to Kent County Cmh Authority (Grand Rapids, MI). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Eric Fullen's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Eric Fullen accept?

Health plans from Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company, Priority Health and UnitedHealthcare list Eric Fullen as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Eric Fullen was last updated on March 10, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 months 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.