Kwashia Fuller, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

63669 Issued in TX

Practice address

23051 Kingwood Place Dr Ste 110
Kingwood, TX 77339-3962

Phone

(844) 824-8775

NPI assigned

Dec 12, 2023

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Specialty

Clinical Social Worker

Education

Other, 2016

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1702339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785196800000",
    "number": "1841068582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11535 PEARSALL RD",
            "city": "ATASCOSA",
            "state": "TX",
            "postal_code": "780025150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23051 KINGWOOD PLACE DR STE 110",
            "city": "KINGWOOD",
            "state": "TX",
            "postal_code": "773393962",
            "telephone_number": "844-824-8775"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11535 Pearsall Rd",
            "address_purpose": "LOCATION",
            "city": "Atascosa",
            "state": "TX",
            "postal_code": "780025150",
            "country_code": "US",
            "telephone_number": "210-622-4430",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FULLER",
        "first_name": "KWASHIA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-12-12",
        "last_updated": "2026-07-28",
        "certification_date": "2026-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "63669",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brandy Renee Frye Puckett
• FSJ MD, PLLC (Integrity Healthcare)
• Joyce Wei Fu, R.D.L.D.M.S.
• Cesar Fuentes, PTA
• Kierra Fulks
• Functional Dietetics of Texas, LLC
• Robert Theron Funk II, M.D.
• Christopher S Fyock, PT, DPT
• Erwin Gillego Gabasan, DPT
• Ruta Lee Gaidys, ARNP

• Clinical Social Worker in Kingwood, TX
• Providers in Kingwood, 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 Jul 28, 2026; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.