Teresa Antoinette Fuller, LCSW, LCDC
Social Worker, Clinical in Houston, TX. Individual provider (NPI-1).
NPI number1346846151
StatusActive
Last updated in NPPESAug 13, 2021
Details
- NPI
- 1346846151
- Entity type
- Individual (NPI-1)
- Name
- Teresa Antoinette Fuller
- Credential
- LCSW, LCDC
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Dec 7, 2020
- Certification date
- Aug 13, 2021
- Last updated
- Aug 13, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1041C0700X | Social Worker, Clinical | 61810 | TX | Yes |
| 101YA0400X | Counselor, Addiction (Substance Use Disorder) | 14286 | TX |
Practice location
9898 Bissonnet St Ste 470Houston, TX 77036-8280
Phone 281-888-6137
Mailing address
1918 Woodvale Dr Unit BMissouri City, TX 77489-1421
Phone 281-901-9412
Other practice locations
1918 Woodvale Dr
Missouri City, TX 77489-1421
Missouri City, TX 77489-1421
Phone 281-901-9412
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