MARK P FULLER LCSW, SAC, ICS,
NPI 1780859744
Social Worker - Clinical in Keshena, WI

Active since April 29, 2008
W3275 WOLF RIVER ROAD, KESHENA, WI 54135(715) 799-5451 Get Directions Write a Review

NPPES record last updated: March 18, 2016. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Mark P Fuller Lcsw, Sac, Ics, NPPES

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

MARK P FULLER LCSW, SAC, ICS, (NPI 1780859744) is an individual clinical provider in Keshena, Wisconsin, licensed in Wisconsin (3082-123) and active in the NPI registry since April 2008.

NPPES Registry Identity

NPI1780859744
Entity TypeIndividualMale
Primary Taxonomy1041C0700X
Provider Legal NameMARK P FULLERCredential: LCSW, SAC, ICS,
Location AddressW3275 WOLF RIVER ROADKeshena, WI 54135
Mailing AddressPo Box 970Keshena, WI 54135-0970 · (715) 799-5451
Sole ProprietorNo
Enumeration DateApril 29, 2008
Last NPPES UpdateMarch 18, 2016
NPI 1780859744 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
License Licensed in WI · 3082-123
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.
W3275 WOLF RIVER ROAD, Keshena, WI 54135

Other Identifiers 1

Medicaid39691700WI

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.

Family Medicine
W3275 WOLF RIVER ROAD
KESHENA, WI 54135
Nurse Practitioner (Family)
W3275 WOLF RIVER ROAD
KESHENA, WI 54135
Psychiatry & Neurology (Psychiatry)
W3275 WOLF RIVER ROAD
KESHENA, WI 54135
Psychologist
W3275 WOLF RIVER ROAD
KESHENA, WI 54135
Clinic/Center (Mental Health (Including Community Mental Health Center))
W3275 WOLF RIVER ROAD
KESHENA, WI 54135
Dentist (General Practice)
W3275 WOLF RIVER ROAD, MENOMINEE TRIBAL CLINIC
KESHENA, WI 54135
Clinic/Center (Family Planning, Non-Surgical)
W3275 WOLF RIVER ROAD
KESHENA, WI 54135
Optometrist
W3275 WOLF RIVER ROAD
KESHENA, WI 54135

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 Mark Fuller's NPI number?

The NPI number for Mark Fuller is 1780859744. It was assigned to this individual provider in the NPPES registry on April 29, 2008.

Where is Mark Fuller located?

Mark Fuller practices at W3275 Wolf River Road, Keshena, WI 54135. The listed phone number is (715) 799-5451.

What is Mark Fuller's specialty?

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

When was this NPI record last updated?

The NPPES record for Mark Fuller was last updated on March 18, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.