MRS. Fatimaah D Fullilove, LSW, LICDC

NPI #1003329228 in Mentor, Ohio

Provider Information

NPI Number: 1003329228
Entity Type: Individual
Name: MRS. Fatimaah D Fullilove, LSW, LICDC
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Social Worker - Clinical
Credential: LSW, LICDC
Enumeration Date: Nov 9, 2017
Last Updated: Feb 25, 2025

Practice Location

Address: 7232 JUSTIN WAY
City: Mentor
State: Ohio
ZIP Code: 44060-4881
Phone: (440) 578-8200

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor - Addiction (Substance Use Disorder) — Addiction (Substance Use Disorder)	101YA0400X
Social Worker	104100000X
Social Worker - Clinical — Clinical	1041C0700X	Primary

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