Provider Demographics
NPI:1588735930
Name:FUELLING & ASSOCIATES LLC
Entity type:Organization
Organization Name:FUELLING & ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:FUELLING
Authorized Official - Suffix:
Authorized Official - Credentials:MS LCSW
Authorized Official - Phone:660-429-6678
Mailing Address - Street 1:PO BOX C
Mailing Address - Street 2:510 E GAY ST STE B
Mailing Address - City:WARRENSBURG
Mailing Address - State:MO
Mailing Address - Zip Code:64093
Mailing Address - Country:US
Mailing Address - Phone:660-429-6678
Mailing Address - Fax:660-429-6672
Practice Address - Street 1:510 E GAY ST STE B
Practice Address - Street 2:
Practice Address - City:WARRENSBURG
Practice Address - State:MO
Practice Address - Zip Code:64093
Practice Address - Country:US
Practice Address - Phone:660-429-6678
Practice Address - Fax:660-429-6672
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)