Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1033628805 Individual Practitioner Male Practitioner

Dr. Dwight E Fultz , PhD, LP

Psychologist • Park Rapids, MN

Professional Overview & Biography Verified Profile Summary

Dr. Dwight Fultz, PhD, LP is a registered healthcare professional specializing in Psychologist in Park Rapids, MN. Practice services are available at 1003 HOLLINGER ST under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

1003 Hollinger St

Park Rapids, MN 564701300

Telephone 2183662636
Fax 2183662087
Associated Practice Facility / Clinic
🏢 Stellher Human Services, Inc. Facility NPI 1285706275

Specialty Benchmarks & Practice Insights

Comparative analytics for Psychologist in Park Rapids, MN

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 30.0 Yrs
State Avg: 22.6 Yrs
Regional Practice Density
3 Specialists

Practicing in Park Rapids, MN (1833 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Psychologist Primary Specialty

NUCC Taxonomy Code: 103T00000X

State License MN LP4277

A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.

Additional State Medicaid & Healthcare Payer Identifiers

Commercial Insurance / Payer ID State Of Minnesota - Minnesota Board Of Psychology
LP4277 (MN)

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

1 Associated Practitioners
Sarah Johnson , LGSW

Social Worker - Clinical

NPI 1467975805

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events
NPI Profile Active September 25, 2017

NPI status registered as active in NPPES database

📍
Updated Practice Location September 25, 2017

Registered at 1003 HOLLINGER ST, PARK RAPIDS, MN 564701300 (Tel: 2183662636)

📍
Updated Business Mailing Address September 25, 2017

Registered at 2310 S LAKE IRVING DR SW, BEMIDJI, MN 566018859 (Tel: 2187511811)

👤
Provider Name / Credentials Updated September 25, 2017

Recorded as DWIGHT FULTZ, PHD, LP

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) September 25, 2017

Psychologist (License #LP4277 in MN)

🟢
Initial NPI Registration & Enumeration September 25, 2017

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1033628805
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: September 25, 2017
Last Update: September 25, 2017
Sole Proprietor: Yes

Mailing Address

2310 S Lake Irving Dr Sw

Bemidji, MN 566018859

Phone: 2187511811

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.