Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mark P Fuller, LCSW, SAC, ICS

Individual provider Clinical Social Worker · NPI 1780859744

Mark P Fuller, LCSW, SAC, ICS is a Clinical Social Worker in Keshena, Wisconsin. Licensed in Wisconsin. Registered with an NPI since 2008.

Licensed in
WI
In the registry since
2008
What do these letters mean?
LCSW — Licensed Clinical Social Worker
A social worker licensed to diagnose and treat mental health conditions independently.

See every abbreviation used in this directory →

Practice location Address checks out

W3275 Wolf River Rd
Keshena, WI 54135
Phone: (715) 799-5451
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 3082-123 (WI)

Record details

NPI number1780859744
Entity typeIndividual (Type 1)
GenderMale
Credentials LCSW , SAC , ICS
Sole proprietorNo
NPI enumeratedApril 29, 2008
Last updated in NPPESMarch 18, 2016