Provider Demographics
NPI:1003588948
Name:FULL CIRCLE THERAPY, LLC
Entity Type:Organization
Organization Name:FULL CIRCLE THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LCSW
Authorized Official - Prefix:
Authorized Official - First Name:TRACY
Authorized Official - Middle Name:LYN
Authorized Official - Last Name:MEEK
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:276-738-4831
Mailing Address - Street 1:190 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ABINGDON
Mailing Address - State:VA
Mailing Address - Zip Code:24210-2854
Mailing Address - Country:US
Mailing Address - Phone:276-738-4831
Mailing Address - Fax:844-444-0697
Practice Address - Street 1:190 E MAIN ST
Practice Address - Street 2:
Practice Address - City:ABINGDON
Practice Address - State:VA
Practice Address - Zip Code:24210-2854
Practice Address - Country:US
Practice Address - Phone:276-738-4831
Practice Address - Fax:844-444-0697
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-29
Last Update Date:2021-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty