Individual provider Active NPI

Kate E Fullmer, LMSW

  • Clinical Social Worker
  • Cedar Park, TX
National Provider Identifier
1306568324
Registry record updated Mar 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
112129 Issued in TX
Practice address
345 Cypress Creek Rd Ste 102
Cedar Park, TX 78613-4484
Phone
(210) 399-3252
Fax
(617) 807-0958
NPI assigned
Sep 15, 2022
Last updated
Mar 20, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X LMSW-20814 AZ
Clinical Social Worker 1041C0700X 112129 TX Primary

Addresses

Primary practice location

345 Cypress Creek Rd Ste 102
Cedar Park, TX 78613-4484

Mailing address

23380 N 61St Dr
Glendale, AZ 85310-5748
Phone (602) 358-7073

Other identifiers 1

IdentifierTypeStateIssuer
LMSW-6907TOtherAZAZ BOARD OF BEHAVIORAL HEALTH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LMSW-20814AZMDSocial Worker
112129TXMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Oceanbee Wellness, LLC Clinical CurrentSince Dec 8, 2024 Accepting new patients
Thrive Counseling LLC PastSince Aug 24, 2021 Accepting new patients
Teri's Health Services PastSince Sep 20, 2022 Accepting new patients

Locations

14040 N Cave Creek Rd
Ste 108
Phoenix, AZ 85022
Phone (602) 358-7073

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1663200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773964800000",
    "number": "1306568324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23380 N 61ST DR",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853105748",
            "telephone_number": "602-358-7073",
            "fax_number": "888-927-0409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "345 CYPRESS CREEK RD STE 102",
            "city": "CEDAR PARK",
            "state": "TX",
            "postal_code": "786134484",
            "telephone_number": "210-399-3252",
            "fax_number": "617-807-0958"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLMER",
        "first_name": "KATE",
        "middle_name": "E",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-15",
        "last_updated": "2026-03-20",
        "certification_date": "2026-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "AZ",
            "license": "LMSW-20814",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "112129",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AZ BOARD OF BEHAVIORAL HEALTH",
            "identifier": "LMSW-6907T",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cedar Park, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2026; 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.