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MRS. LACREASHA FULLARD CRNP-PMH
NPI 1821696196
Nurse Practitioner - Psychiatric/Mental Health in Nottingham, MD

Active since October 09, 2020PECOS Enrolled
9649 BELAIR RD STE 104, NOTTINGHAM, MD 21236(410) 529-1309(410) 529-1005 Get Directions Write a Review

NPPES record last updated: August 8, 2023. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Aug 8, 2023, Jul 3, 2023, Oct 16, 2020 and 1 more (4 updates tracked since 2020).

About Mrs. Lacreasha Fullard Crnp-pmh NPPES

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

MRS. LACREASHA FULLARD CRNP-PMH (NPI 1821696196) is an individual psychiatric/mental health provider in Nottingham, Maryland, licensed in Maryland (R219476) and active in the NPI registry since October 2020. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1821696196
Entity TypeIndividualFemale
Primary Taxonomy363LP0808X
Provider Legal NameMRS. LACREASHA FULLARDCredential: CRNP-PMH
Location Address9649 BELAIR RD STE 104Nottingham, MD 21236-1117
Mailing Address9649 Belair Rd Ste 104Nottingham, MD 21236-1117 · (410) 529-1309 · Fax (410) 529-1005
Phone(410) 529-1309
Fax(410) 529-1005
Sole ProprietorYes
Enumeration DateOctober 9, 2020
Last NPPES UpdateAugust 8, 20234 updates tracked since enumeration
NPPES CertifiedAugust 3, 2023
✔ NPI 1821696196 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0808X
License✔ Licensed in MD · R219476
9649 BELAIR RD STE 104, Nottingham, MD 21236
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mrs. Lacreasha Fullard Crnp-pmh 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 Reassignments

3

Medicare enrollment records show Lacreasha Fullard reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Well Life Counseling And Consulting, LLC
Same address
Clinical
9649 BELAIR RD STE 104
Nottingham, MD 21236
  • Reassigned Medicare billing, Maryland enrollment
  • 14 clinicians in this Medicare group
NPI 1891190054 (410) 529-1309
Mindful Haven LLC
0.2 mi
Psychiatric/Mental Health
9706 BELAIR RD # 101-102
Nottingham, MD 21236
  • Reassigned Medicare billing, Maryland enrollment
  • 3 clinicians in this Medicare group
NPI 1093563512 (410) 630-8292
Norkris Services, Inc
22 mi
Community/Behavioral Health
611 S UNION AVE
Havre De Grace, MD 21078
  • Reassigned Medicare billing, Maryland enrollment
  • 12 clinicians in this Medicare group
NPI 1487025094 (443) 526-6133

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 21236 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
$94.08 typical visit price
range $60.73 – $183.44
Typical copayment $23.52 (range $15.18 – $45.86)
Most-billed visit code 99203
Established Patient
$106.59 typical visit price
range $19.60 – $149.17
Typical copayment $26.64 (range $4.90 – $37.29)
Most-billed visit code 99214
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.

LOREDANA PETRUCCI PH.D
Psychologist
9649 BELAIR RD STE 104
NOTTINGHAM, MD 21236
Baltimore County (410) 529-1309
CHRISTOPHER FARIA LCPC
Counselor (Professional)
9649 BELAIR RD STE 104
NOTTINGHAM, MD 21236
Baltimore County (410) 529-1309
JOHANNE ELAINE ETIENNE ZAWITOSKI LMSW
Social Worker (Clinical)
9649 BELAIR RD STE 104
NOTTINGHAM, MD 21236
Baltimore County (410) 529-1309
MISS RYANN NICOLE SIEGEL PSYCHOLOGY ASSOCIATE
Counselor
9649 BELAIR RD STE 104
NOTTINGHAM, MD 21236
Baltimore County (410) 529-1309
BAILEY PARARAS LMSW
Social Worker (Clinical)
9649 BELAIR RD STE 104
NOTTINGHAM, MD 21236
Baltimore County (410) 529-1309
SARAH FEDER
Psychologist
9649 BELAIR RD STE 104
NOTTINGHAM, MD 21236
Baltimore County (410) 529-1309
ETHAN CUTTLER
Psychologist
9649 BELAIR RD STE 104
NOTTINGHAM, MD 21236
Baltimore County (410) 529-1309
MRS. ASHLEY GAMATORIA LCSW-C
Social Worker (Clinical)
9649 BELAIR RD STE 104
NOTTINGHAM, MD 21236
Baltimore County (410) 529-1309

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 Lacreasha Fullard's NPI number?

The NPI number for Lacreasha Fullard is 1821696196. It was assigned to this individual provider in the NPPES registry on October 9, 2020.

Where is Lacreasha Fullard located?

Lacreasha Fullard practices at 9649 Belair Rd Ste 104, Nottingham, MD 21236. The listed phone number is (410) 529-1309.

What is Lacreasha Fullard's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Is Lacreasha Fullard enrolled in Medicare?

Yes. Lacreasha Fullard is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Lacreasha Fullard's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Lacreasha Fullard reassigns Medicare benefits to 3 organizations: Well Life Counseling And Consulting, LLC (Nottingham, MD), Mindful Haven LLC (Nottingham, MD) and Norkris Services, Inc (Havre De Grace, MD). Each 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 Lacreasha Fullard's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Lacreasha Fullard was last updated on August 8, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.