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DAVIDA DAWANA FULLER LCSW
NPI 1023858172
Social Worker - Clinical in Chicago, IL

Active since May 28, 2024PECOS Enrolled
2000 N RACINE AVE STE 3300, CHICAGO, IL 60614(773) 413-9523 Get Directions Write a Review

NPPES record last updated: May 28, 2024. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Davida Dawana Fuller Lcsw NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DAVIDA DAWANA FULLER LCSW (NPI 1023858172) is an individual clinical provider in Chicago, Illinois, licensed in Illinois (149027199) and active in the NPI registry since May 2024. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1023858172
Entity TypeIndividualFemale
Primary Taxonomy1041C0700X
Provider Legal NameDAVIDA DAWANA FULLERCredential: LCSW
Location Address2000 N RACINE AVE STE 3300Chicago, IL 60614-7008
Mailing Address2000 N Racine Ave Ste 3300Chicago, IL 60614-7008 · (773) 413-9523
Phone(773) 413-9523
Sole ProprietorYes
Enumeration DateMay 28, 2024
NPPES CertifiedMay 28, 2024
✔ NPI 1023858172 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
License✔ Licensed in IL · 149027199
Definition
A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
2000 N RACINE AVE STE 3300, Chicago, IL 60614
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Davida Dawana Fuller Lcsw is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Davida Fuller reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Grow Healthcare Group PA
1,191 mi
Mental Health
66 W FLAGLER ST STE 900
Miami, FL 33130
  • Reassigned Medicare billing, Illinois enrollment
  • 581 clinicians in this Medicare group
NPI 1245845932 (786) 244-7711

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 60614 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$0.00 typical visit price
range $60.08 – $183.39
Typical copayment $0.00 (range $15.02 – $45.84)
Most-billed visit code NA
Established Patient
$74.80 typical visit price
range $18.97 – $148.12
Typical copayment $18.70 (range $4.74 – $37.03)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

BRITTANY GARDNER
Social Worker (Clinical)
2000 N RACINE AVE STE 3300
CHICAGO, IL 60614
Cook County (773) 413-9523
MARLENE PENA LSW
Social Worker
2000 N RACINE AVE STE 3300
CHICAGO, IL 60614
Cook County (773) 413-9523
RACHAEL MARY DRAPCHO LPC
Counselor (Professional)
2000 N RACINE AVE STE 3300
CHICAGO, IL 60614
Cook County (773) 413-9523
JULIA BRAY CRISMAN
Counselor (Mental Health)
2000 N RACINE AVE STE 3300
CHICAGO, IL 60614
Cook County (773) 413-9523
SHANITA BROWN
Social Worker (Clinical)
2000 N RACINE AVE STE 3300
CHICAGO, IL 60614
Cook County (708) 629-9756
JANINE ELINA SNYDER LCSW
Social Worker (Clinical)
2000 N RACINE AVE STE 3300
CHICAGO, IL 60614
Cook County (773) 413-9523
SAMANTHA CAMPBELL MSW, LSW
Social Worker
2000 N RACINE AVE STE 3300
CHICAGO, IL 60614
Cook County (773) 413-9523
MRS. REBECCA J ROBERTS LCPC
Counselor (Mental Health)
2000 N RACINE AVE STE 3300
CHICAGO, IL 60614
Cook County (773) 413-9523

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Davida Fuller's NPI number?

The NPI number for Davida Fuller is 1023858172. It was assigned to this individual provider in the NPPES registry on May 28, 2024.

Where is Davida Fuller located?

Davida Fuller practices at 2000 N Racine Ave Ste 3300, Chicago, IL 60614. The listed phone number is (773) 413-9523.

What is Davida Fuller's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Is Davida Fuller enrolled in Medicare?

Yes. Davida Fuller is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Davida Fuller's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Davida Fuller reassigns Medicare benefits to Grow Healthcare Group PA (Miami, FL). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Davida Fuller's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Davida Fuller was last updated on May 28, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.