Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Dr. Katina Felisa Fuller, DSW, LCSW, CCM

Individual provider Clinical Social Worker · NPI 1598546194

Dr. Katina Felisa Fuller, DSW, LCSW, CCM is a Clinical Social Worker in Villa Rica, Georgia. Practices as a sole proprietor. Licensed in Georgia.

Licensed in
GA
In the registry since
2023
What do these letters mean?
LCSW — Licensed Clinical Social Worker
A social worker licensed to diagnose and treat mental health conditions independently.

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Practice location Address checks out

212 Bonnie Sue Dr
Villa Rica, GA 30180-5517
Phone: (678) 739-8497
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence CSW007891 (GA)

Record details

NPI number1598546194
Entity typeIndividual (Type 1)
GenderFemale
Credentials DSW , LCSW , CCM
Sole proprietorYes
NPI enumeratedOctober 10, 2023
Last updated in NPPESOctober 10, 2023
Certification dateOctober 10, 2023

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