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NPI Code Detail

MEDICARE: MR. ANTHONY FULCO III LCSW

MEDICARE: MR. ANTHONY FULCO III LCSW
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
1104100000XSocial Worker093367-1NY
2104100000XSocial Worker11680-CNV

General Provider Information

NPI Number : 1851830863
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. ANTHONY FULCO III LCSW
Provider Business Mailing Address
First Line : 5584 S FORT APACHE RD
Second Line :
City : LAS VEGAS
State : NV
Zip : 89148-7657
Country : US
Telephone Number : 702-296-1222
Fax Number :
Provider Business Practice Location Address
First Line : 5584 S FORT APACHE RD
Second Line :
City : LAS VEGAS
State : NV
Zip : 89148-7657
Country : US
Telephone Number : 702-296-1222
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/23/2017
Last Update Date : 02/06/2026

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