Individual Healthcare Provider
Constance Fullwood, PHNL, PMHNP-BC
Provider's NPPES record last updated: August 5, 2026
Overview
- Entity Type
- Individual Healthcare Provider
- NPI
- 1134798663
- Primary Specialty
- Nurse Practitioner — Psychiatric/Mental Health
- Practice Location
- Long Island City, New York
- Sole Proprietor
- Yes
Federal Screening
NPISignal checked this NPI against federal exclusion sources. Results below are based on the NPI number itself — an identifier match, not a name match.
List of Excluded Individuals/Entities (LEIE)
HHS Office of Inspector General
No potential match was identified in NPISignal's indexed List of Excluded Individuals/Entities (LEIE) records as of 2026-09-10.
- Source data
- September 10, 2026
- Records indexed
- 84,001
- Screened
- Sep 20, 2026, 3:40 PM UTC
This reflects only the records NPISignal currently holds and the identity information supplied. It is not a verification of eligibility, licensure, or compliance. Verify decisions that matter against the authoritative source.
SAM.gov Exclusions
U.S. General Services Administration
SAM.gov Exclusions was not checked.
SAM.gov screening is not configured on this deployment. No SAM check has been performed.
- Screened
- Not checked
This is an NPI-based check only. NPISignal does not publish name-based exclusion matches on a provider profile. A shared or similar name is a lead that requires human review, not an identification, and this page is not the place to make one. Run a name-based screening below to see potential matches with the reasons for each.
This reflects only the records NPISignal currently holds and the identity information supplied. It is not a verification of eligibility, licensure, or compliance. Verify decisions that matter against the authoritative source.
Searches OIG LEIE and SAM.gov by name and reviews every potential match.
Specialties & Taxonomies
- Primary
Nurse Practitioner
Psychiatric/Mental Health
Physician Assistants & Advanced Practice Nursing Providers
Definition to come...
Taxonomy code 363LP0808X
Provider-Reported License Information
- Nurse Practitioner (New York)
- F405449-01
- Nurse Practitioner (Massachusetts)
- RN250856
Practice Locations
Practice Location
36-11 21st St
Long Island City, New York 11106-4505
Phone: (718) 482-7772
Additional Practice Location
81 W 115th St
New York, New York 10026-3138
Phone: (212) 426-0088
Fax: (212) 426-8367
Additional Practice Location
975 Westchester Ave
Bronx, New York 10459-3204
Phone: (718) 320-4466
Fax: (718) 991-3829
Additional Practice Location
89-44 164th St
Jamaica, New York 11432-6103
Phone: (718) 523-2123
Fax: (718) 523-5833
Additional Practice Location
2301 Dorsey Rd Ste 200
Glen Burnie, Maryland 21061-3275
Phone: (410) 768-0123
Additional Practice Location
999 Blake Ave
Brooklyn, New York 11208-3535
Phone: (718) 277-8303
Fax: (718) 277-4795
Additional Practice Location
1167 Nostrand Ave
Brooklyn, New York 11225-5417
Phone: (718) 778-0198
Fax: (718) 221-8169
Additional Practice Location
2581 Atlantic Ave
Brooklyn, New York 11207-2412
Phone: (718) 495-6700
Fax: (646) 988-2840
Additional Practice Location
504 W 158th St Fl 5
New York, New York 10032-7202
Phone: (917) 521-3130
Additional Practice Location
1880 Bathgate Ave
Bronx, New York 10457-6259
Phone: (718) 294-5891
Fax: (718) 294-2468
Additional Practice Location
511 W 157th St
New York, New York 10032-5058
Phone: (212) 781-7979
Fax: (212) 781-7963
Additional Practice Location
350 Grand St Rm 240
New York, New York 10002-4629
Phone: (212) 634-7550
Additional Practice Location
255 E Houston St
New York, New York 10002-1013
Phone: (212) 477-1120
Fax: (212) 477-8957
Additional Practice Location
94-98 Manhattan Avenue
Brooklyn, New York 11206-2505
Phone: (718) 388-0390
Fax: (718) 486-5741
Record Information
- Enumeration Date
- June 19, 2021
- Provider's NPPES Record Last Updated
- August 5, 2026
- Certification Date
- August 5, 2026
- NPISignal NPPES Dataset
- August 2026
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