# JAMES W FULLER PHD INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1518054733
- **Authorized official:** DR. JAMES WOODROW FULLER JR. PHD (CEP)
- **Authorized official phone:** (804) 967-0486

## Contact information

- **Practice address:** 5412 GLENSIDE DR STE B, RICHMOND, VA 23228-3995
- **Practice address phone:** (804) 967-0486
- **Practice address fax:** (804) 346-0066
- **Mailing address:** 2410 LARKWOOD ROAD, RICHMOND, VA 23294-4105
- **Mailing address phone:** (804) 967-0486

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1041C0700X | Clinical Social Worker | 0904000574 | VA | Yes |

## Other

- **Enumeration date:** 10/08/2006
- **Last updated:** 05/07/2008