Individual provider Active NPI

Seymone Fuller, MSW, RSWI

  • Clinical Social Worker
  • Tallahassee, FL
National Provider Identifier
1972273688
Registry record updated Sep 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
ISW15973 Issued in FL
Practice address
2403 Hartsfield Rd Apt 601
Tallahassee, FL 32303-8358
Phone
(904) 466-5613
NPI assigned
Sep 14, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 14, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X ISW15973 FL Primary

Addresses

Primary practice location

2403 Hartsfield Rd Apt 601
Tallahassee, FL 32303-8358

Mailing address

2403 Hartsfield Rd Apt 601
Tallahassee, FL 32303-8358
Phone (904) 466-5613

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
ISW15973FLMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1631577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631577600000",
    "number": "1972273688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2403 HARTSFIELD RD APT 601",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323038358",
            "telephone_number": "904-466-5613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2403 HARTSFIELD RD APT 601",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323038358",
            "telephone_number": "904-466-5613"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLER",
        "first_name": "SEYMONE",
        "credential": "MSW, RSWI",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-09-14",
        "last_updated": "2021-09-14",
        "certification_date": "2021-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "ISW15973",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tallahassee, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2021; 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.