Sonya Latrice Fuller, MSW, LISW-S

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

I.1600316-SUPV Issued in OH

Practice address

38616 Fairway Glenn Blvd
Willoughby, OH 44094-7188

Phone

(216) 326-4752

NPI assigned

Oct 29, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Mrs. Sonya Latrice Rembert Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1603929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603929600000",
    "number": "1275133068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38616 FAIRWAY GLENN BLVD",
            "city": "WILLOUGHBY",
            "state": "OH",
            "postal_code": "440947188",
            "telephone_number": "216-326-4752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "38616 FAIRWAY GLENN BLVD",
            "city": "WILLOUGHBY",
            "state": "OH",
            "postal_code": "440947188",
            "telephone_number": "216-326-4752"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLER",
        "first_name": "SONYA",
        "middle_name": "LATRICE",
        "name_prefix": "Mrs.",
        "credential": "MSW, LISW-S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-10-29",
        "last_updated": "2020-10-29",
        "certification_date": "2020-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.1600316-SUPV",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SONYA",
            "last_name": "REMBERT",
            "middle_name": "LATRICE",
            "prefix": "MRS.",
            "credential": "MSW, LISW-S",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Carolyn Frink
• Laura Lee Frycklund, NP
• Fuentes Counseling Services
• Debra Lee Fuentes, LPCC-SUPV, LICDC-CS
• Marketa Fuller-President
• Lisa Marie Fulton, RN
• Elena Furman, D.M.D.
• Camille Futrell
• Jayson Gage
• Ashia Gaines

• Clinical Social Worker in Willoughby, OH
• Providers in Willoughby, 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 Oct 29, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.