Provider Demographics
NPI:1619270782
Name:FULL CIRCLE FAMILY COUNSELING, PLLC
Entity Type:Organization
Organization Name:FULL CIRCLE FAMILY COUNSELING, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:TRACEY
Authorized Official - Middle Name:
Authorized Official - Last Name:TURNER-KEYSER
Authorized Official - Suffix:
Authorized Official - Credentials:MA, BC-DMT, LPC-S
Authorized Official - Phone:919-545-9833
Mailing Address - Street 1:5089 US HIGHWAY 64 W
Mailing Address - Street 2:
Mailing Address - City:PITTSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27312-6829
Mailing Address - Country:US
Mailing Address - Phone:919-545-9833
Mailing Address - Fax:919-545-9832
Practice Address - Street 1:5089 US HIGHWAY 64 W
Practice Address - Street 2:
Practice Address - City:PITTSBORO
Practice Address - State:NC
Practice Address - Zip Code:27312-6829
Practice Address - Country:US
Practice Address - Phone:919-545-9833
Practice Address - Fax:919-545-9832
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-13
Last Update Date:2013-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4468101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty