MEDICARE: DR. KIMBERLY A FULLER LISW-S

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	S.1200645	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1083053375
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KIMBERLY A FULLER LISW-S

Provider Business Mailing Address
First Line	:	3500 LORAIN AVE STE 300
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44113-3726
Country	:	US
Telephone Number	:	216-250-1607
Fax Number	:	216-304-6669

Provider Business Practice Location Address
First Line	:	3500 LORAIN AVE STE 407
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44113-3726
Country	:	US
Telephone Number	:	216-250-1607
Fax Number	:	216-304-6669

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/19/2013
Last Update Date	:	02/12/2026

Similar Medicare Providers

1184554925 — DYLAN HACKNEY CT
Practice Location Address:

3500 LORAIN AVE STE 407
CLEVELAND, OH
44113-3726

Practice Phone: 216-250-1607
Practice Fax: 216-304-6669

1538489091 — EMILY ROLL MSSA, LISW-S
Practice Location Address:

3500 LORAIN AVE STE 407
CLEVELAND, OH
44113-3726

Practice Phone: 216-200-8543
Practice Fax: 216-744-1114

1972020790 — JESSIE ALLAN LEU
Practice Location Address:

3500 LORAIN AVE STE 407
CLEVELAND, OH
44113-3726

Practice Phone: 216-250-1607
Practice Fax: 216-304-6669

1912426230 — SAMUEL ELLIOTT BERNHOFER LPCC
Practice Location Address:

3500 LORAIN AVE STE 300
CLEVELAND, OH
44113-3726

Practice Phone: 216-630-4658
Practice Fax:

1518579101 — ELLIOT CARSON WILLIAMS LSW
Practice Location Address:

3500 LORAIN AVE STE 300
CLEVELAND, OH
44113-3726

Practice Phone: 216-250-1607
Practice Fax: 216-304-6669

1982203246 — CLEVELAND SEX & INTIMACY COUNSELING
Practice Location Address:

3500 LORAIN AVE STE 301
CLEVELAND, OH
44113-3726

Practice Phone: 216-250-1607
Practice Fax: 216-304-6669

Directions to “ DR. KIMBERLY A FULLER LISW-S” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.