DR. KATINA FELISA FULLER DSW, LCSW, CCM
NPI 1598546194
Social Worker - Clinical in Villa Rica, GA

Active since October 10, 2023
212 BONNIE SUE DR, VILLA RICA, GA 30180(678) 739-8497 Get Directions Write a Review

NPPES record last updated: October 10, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Dr. Katina Felisa Fuller Dsw, Lcsw, Ccm NPPES

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

DR. KATINA FELISA FULLER DSW, LCSW, CCM (NPI 1598546194) is an individual clinical provider in Villa Rica, Georgia, licensed in Georgia (CSW007891) and active in the NPI registry since October 2023.

NPPES Registry Identity

NPI1598546194
Entity TypeIndividualFemale
Primary Taxonomy1041C0700X
Provider Legal NameDR. KATINA FELISA FULLERCredential: DSW, LCSW, CCM
Location Address212 BONNIE SUE DRVilla Rica, GA 30180-5517
Mailing Address212 Bonnie Sue DrVilla Rica, GA 30180-5517 · (678) 739-8497
Sole ProprietorYes
Enumeration DateOctober 10, 2023
NPPES CertifiedOctober 10, 2023
NPI 1598546194 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 GA · CSW007891
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.
212 BONNIE SUE DR, Villa Rica, GA 30180

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 Katina Fuller's NPI number?

The NPI number for Katina Fuller is 1598546194. It was assigned to this individual provider in the NPPES registry on October 10, 2023.

Where is Katina Fuller located?

Katina Fuller practices at 212 Bonnie Sue Dr, Villa Rica, GA 30180. The listed phone number is (678) 739-8497.

What is Katina Fuller's specialty?

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

When was this NPI record last updated?

The NPPES record for Katina Fuller was last updated on October 10, 2023. 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.