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Individual
KATE E FULLMER
Active
Individual
KATE E FULLMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
LMSW-20814
AZ
104100000X
Social Worker
Primary
LMSW-6907T
AZ
1041C0700X
Clinical Social Worker
Primary
112129
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LMSW-6907T
AZ BOARD OF BEHAVIORAL HEALTH
AZ
Enumeration date
09/15/2022
Last updated
03/20/2026
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