Dr. Constance Fullwood, PHNL, PMHNP-BC

Practice location Address checks out

36-11 21st St
Long Island City, NY 11106-4505
Phone: (718) 482-7772
Fax: (718) 482-9648

Additional practice locations (13)

• 2301 Dorsey Rd Ste 200, Glen Burnie, MD 21061-3275 — (410) 768-0123
• 975 Westchester Ave, Bronx, NY 10459-3204 — (718) 320-4466
• 1880 Bathgate Ave, Bronx, NY 10457-6259 — (718) 294-5891
• 2581 Atlantic Ave, Brooklyn, NY 11207-2412 — (718) 495-6700
• 999 Blake Ave, Brooklyn, NY 11208-3535 — (718) 277-8303
• 1167 Nostrand Ave, Brooklyn, NY 11225-5417 — (718) 778-0198
• 94-98 Manhattan Avenue, Brooklyn, NY 11206-2505 — (718) 388-0390
• 89-44 164th St, Jamaica, NY 11432-6103 — (718) 523-2123
• 81 W 115th St, New York, NY 10026-3138 — (212) 426-0088
• 511 W 157th St, New York, NY 10032-5058 — (212) 781-7979
• 350 Grand St Rm 240, New York, NY 10002-4629 — (212) 634-7550
• 255 E Houston St, New York, NY 10002-1013 — (212) 477-1120
• 504 W 158th St Fl 5, New York, NY 10032-7202 — (917) 521-3130

Specialties & licences

Psychiatric/Mental Health Nurse Practitioner (primary)	Taxonomy 363LP0808X · Licence F405449-01 (NY)
Psychiatric/Mental Health Nurse Practitioner	Taxonomy 363LP0808X · Licence RN250856 (MA)

Record details

NPI number	1134798663
Entity type	Individual (Type 1)
Gender	Female
Credentials	PHNL , PMHNP-BC
Sole proprietor	Yes
NPI enumerated	June 19, 2021
Last updated in NPPES	August 5, 2026
Certification date	August 5, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialty	NURSE PRACTITIONER
Medical school	OTHER
Graduated	2020 (6 years in practice)
Group practice	Upper Manhattan Mental Health Center, Inc. — 10 clinicians
Accepts Medicare assignment	Yes — accepts the Medicare-approved amount
Telehealth	Offers telehealth services