Provider Demographics
NPI:1114532504
Name:FULL CIRCLE COMMUNITY
Entity Type:Organization
Organization Name:FULL CIRCLE COMMUNITY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:
Authorized Official - Last Name:YOUNG
Authorized Official - Suffix:
Authorized Official - Credentials:PHD PSYCHOLOGY
Authorized Official - Phone:828-222-0401
Mailing Address - Street 1:1915 GEORGE ST
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28792-2948
Mailing Address - Country:US
Mailing Address - Phone:828-222-0401
Mailing Address - Fax:888-876-4026
Practice Address - Street 1:1915 GEORGE ST
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28792-2948
Practice Address - Country:US
Practice Address - Phone:828-222-0401
Practice Address - Fax:888-876-4026
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-11
Last Update Date:2020-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty