Clifton Henry Fuller, LCSW, LPC, LMFT

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

299 Issued in TX

Practice address

12951 Huebner Rd
Ste 781466
San Antonio, TX 78230-9998

Phone

(210) 970-1511

Fax

(210) 614-9911

NPI assigned

Aug 16, 2006

Reactivated

Mar 27, 2023

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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 and National Provider Directory roles.

• C.H. Fuller & Associates LLC

  • Clinical Social Worker
  • San Antonio, TX
  • NPI 1609203413

  Professional

  NPD Authorized official

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

{
    "created_epoch": "1155686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693180800000",
    "number": "1831202613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12951 HUEBNER RD",
            "address_2": "STE 781466",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782309998",
            "telephone_number": "210-970-1511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12951 HUEBNER RD",
            "address_2": "STE 781466",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782309998",
            "telephone_number": "210-970-1511",
            "fax_number": "210-614-9911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLER",
        "first_name": "CLIFTON",
        "middle_name": "HENRY",
        "name_prefix": "Mr.",
        "credential": "LCSW, LPC, LMFT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-16",
        "last_updated": "2023-08-28",
        "certification_date": "2023-03-27",
        "deactivation_date": "2023-01-06",
        "reactivation_date": "2023-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "#09189",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "9189",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "TX",
            "license": "1081",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "299",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMPLOYEE IDENTIFICATION #",
            "identifier": "742637802",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "https://CliftonFuller.com",
            "affiliation": "N",
            "endpointDescription": "website",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "website",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "website",
            "address_1": "15303 Huebner Rd",
            "address_2": "#10",
            "city": "San Antonio",
            "state": "TX",
            "country_code": "US",
            "postal_code": "782480959",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Fuller-Selle, LLC
• Alisa Scott Fuller, RBT
• Amy M Fuller, PHD
• Catherine Marie Fuller, MS, FNP-C
• Christopher Fuller, LPC
• Dane Fuller
• Gerry L. Fuller, LCSW
• Pamela Fay Fuller
• Terrance Fuller
• Chelsea Fulton, OTA

• Clinical Social Worker in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Clinical Social Worker in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2023; 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.