Provider Demographics
NPI:1164526539
Name:FULCHER, ANDREA (LCSW)
Entity type:Individual
Prefix:MRS
First Name:ANDREA
Middle Name:
Last Name:FULCHER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8266 PINTO DR
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33467-1155
Mailing Address - Country:US
Mailing Address - Phone:561-460-3178
Mailing Address - Fax:
Practice Address - Street 1:8266 PINTO DR
Practice Address - Street 2:
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33467-1155
Practice Address - Country:US
Practice Address - Phone:561-460-3178
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-07
Last Update Date:2025-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLZ5819ZOtherPROVIDER
FLZ5819ZOtherPROVIDER