Provider Demographics
NPI:1598337917
Name:FULL CIRCLE PSYCHOLOGY AFFILIATES, LLC
Entity Type:Organization
Organization Name:FULL CIRCLE PSYCHOLOGY AFFILIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:ANTHONY
Authorized Official - Suffix:
Authorized Official - Credentials:EDS, PHD, HSP
Authorized Official - Phone:319-214-7511
Mailing Address - Street 1:373 COLLINS RD NE STE 203
Mailing Address - Street 2:
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52402-3167
Mailing Address - Country:US
Mailing Address - Phone:319-214-7511
Mailing Address - Fax:319-214-7512
Practice Address - Street 1:373 COLLINS RD NE STE 203
Practice Address - Street 2:
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52402-3167
Practice Address - Country:US
Practice Address - Phone:319-214-7511
Practice Address - Fax:319-214-7512
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-14
Last Update Date:2021-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health