MEDICARE: DR. CAROLINE E FULTON PSYD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	071.010346	IL
2	103TC2200X	Clinical Child & Adolescent Psychologist	PS02327	RI
3	103TC2200X	Clinical Child & Adolescent Psychologist	071010346	IL
4	103TC0700X	Clinical Psychologist	PS02327	RI

General Provider Information

NPI Number	:	1184223364
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CAROLINE E FULTON PSYD

Provider Business Mailing Address
First Line	:	420 SCRABBLETOWN RD STE A
Second Line	:
City	:	NORTH KINGSTOWN
State	:	RI
Zip	:	02852-3638
Country	:	US
Telephone Number	:	401-268-5333
Fax Number	:	855-268-5333

Provider Business Practice Location Address
First Line	:	175 NATE WHIPPLE HWY STE 202
Second Line	:
City	:	CUMBERLAND
State	:	RI
Zip	:	02864-1423
Country	:	US
Telephone Number	:	401-405-0700
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/20/2020
Last Update Date	:	08/18/2025

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