Donna Fasullo is a Clinical in League City, Texas. Donna Fasullo practices all healthcare services and medical treatments related to Clinical. The NPI Number for Donna Fasullo is 1326006735. The last update date is 2009-06-23.
Donna Fasullo's current location address is 3027 Marina Bay Dr, League City, Texas. You can contact this provider via phone number 7136877644 and fax number 2812406481. The mailing address for Donna Fasullo is 3027 Marina Bay Dr, League City, Texas. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Donna Fasullo |
|---|---|
| Address | 3027 Marina Bay Dr, League City, Texas |
| Phone Number | 7136877644 |
| Fax Number | 2812406481 |
| Sole Proprietor | Y |
| Credentials | LCSW |
NPI Number Detail
| NPI Number | 1326006735 |
|---|---|
| Provider Enumeration Date | 2006-05-03 |
| Last Updated Date | 2009-06-23 |
Provider Mailing Address Detail
| Address | 3027 Marina Bay Dr |
|---|---|
| City | League City |
| State | Texas (TX) |
| Post Code | 775732729 |
| Phone Number | 7136877644 |
| Fax Number | 2812406481 |
Provider's Primary Taxonomy Detail
| Speciality | Clinical |
|---|---|
| Taxonomy | 1041C0700X |
| Licence No | 1041C0700X |
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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, certif |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 146355602 | TX | -- | |
| 00S03P | TX | BC/BS | |
| 124104401 | TX | -- |
Post Comment/ Review Below
What is the Donna Fasullo's unique identification number?
The Donna Fasullo has been assigned the NPI (National Provider Identifier) Number 1326006735 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for the organization.
Could you share the physical location details of Donna Fasullo?
The Donna Fasullo is situated at 3027 Marina Bay Dr, in the city of League City, state of TX, with the zip code 775732729.
What is the Donna Fasullo's specialty and taxonomy code?
The Donna Fasullo's specialty is Clinical, and the corresponding taxonomy code is 1041C0700X.
On what date did Donna Fasullo receive its 1326006735 assignment from the Centers for Medicare & Medicaid Services?
The Donna Fasullo was assigned its 1326006735 on 2006-05-03, which is the date when this unique identifier was issued to the organization by the Centers for Medicare & Medicaid Services.
As of what date were the details related to Donna Fasullo most recently updated or revised?
The information pertaining to Donna Fasullo, including its address, specialty, and other relevant details, was last updated or revised on 2009-06-23.