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

Tessa Fultz, LICSW

Individual provider Clinical Social Worker · NPI 1568968204

Tessa Fultz, LICSW is a Clinical Social Worker in Farmington, Minnesota. Qualified in 2017, 9 years ago. Practices as a sole proprietor and works from 2 locations. Licensed in Minnesota.

Years since qualifying
9
Licensed in
MN
In the registry since
2018
Specialties on file
2
What do these letters mean?
LICSW — Licensed Independent Clinical Social Worker
The title some states use for an independently practising clinical social worker.

See every abbreviation used in this directory →

Practice location Address checks out

408 3rd St Ste 107
Farmington, MN 55024-1355
Phone: (651) 252-4025
Fax: (651) 390-6136
Show map & directions

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

Additional practice locations (1)

  • 1919 Broadway St Ne, Minneapolis, MN 55413-1251 — (651) 252-4025

Specialties & licences

Social Worker (primary) Taxonomy 104100000X · Licence 26216 (MN)
Clinical Social Worker Taxonomy 1041C0700X

Record details

NPI number1568968204
Entity typeIndividual (Type 1)
GenderFemale
Credentials LICSW
Sole proprietorYes
NPI enumeratedApril 2, 2018
Last updated in NPPESOctober 15, 2024
Certification dateOctober 15, 2024

Medicare enrollment

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

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2017 (9 years in practice)
Accepts Medicare assignment Not indicated

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