Fatimaah D Fullilove, LSW, LICDC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

S.2106096 Issued in OH

Practice address

7232 Justin Way
Mentor, OH 44060-4881

Phone

(440) 578-8200

NPI assigned

Nov 9, 2017

Last updated

Feb 25, 2025By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Signature Health, Inc.

  • Mental Health Counselor
  • Garfield Heights, OH
  • NPI 1679767289
  Medicare reassignment NPD
• Signature Health Inc

  dba Signature Health

  • Long Term Care Pharmacy
  • Willoughby, OH
  • NPI 1740502335
  NPD
• Imex Inc

  dba KTA MAT & Recovery

  • Occupational Medicine Physician
  • Chesterland, OH
  • NPI 1194229427

  Addiction (Substance Use Disorder)

  NPD (past)
• Moore Counseling & Mediation Services, Inc.

  • Professional Counselor
  • Euclid, OH
  • NPI 1235242280

  Addiction (Substance Use Disorder)

  NPD (past)
• Warren Recovery Group Inc

  dba Cleveland Family Recovery

  • Community/Behavioral Health Agency
  • Shaker Heights, OH
  • NPI 1891389466
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1510185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740441600000",
    "number": "1003329228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7232 JUSTIN WAY",
            "city": "MENTOR",
            "state": "OH",
            "postal_code": "440604881",
            "telephone_number": "440-578-8200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7232 JUSTIN WAY",
            "city": "MENTOR",
            "state": "OH",
            "postal_code": "440604881",
            "telephone_number": "440-578-8200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1400 E 55th St",
            "address_purpose": "LOCATION",
            "city": "Cleveland",
            "state": "OH",
            "postal_code": "441031304",
            "country_code": "US",
            "telephone_number": "216-391-6672",
            "fax_number": "216-431-4601",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FULLILOVE",
        "first_name": "FATIMAAH",
        "middle_name": "D",
        "name_prefix": "Mrs.",
        "credential": "LSW, LICDC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-11-09",
        "last_updated": "2025-02-25",
        "certification_date": "2025-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "162016",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "2106096",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "S.2106096",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christine Lynch Frey, MED.
• Keith Alan Friedenberg, M.D.
• Lisa A Friend, LISW, CDCA
• Hilary Frohnapfel, RPH
• Christina Joann Fularz, BA
• Tiara Fulton, LPC
• Diane Fultz, LCDCII, SWA, QMHS
• Donna Furlan
• Dorothea Furr
• Amanda M Futkos, RN

• Clinical Social Worker in Mentor, OH
• Providers in Mentor, OH by specialty
• Clinical Social Worker in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.