Healthcare Provider Details

I. General information

NPI: 1124662226
Provider Name (Legal Business Name): FULL CIRCLE FAMILY SOLUTIONS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/31/2019
Last Update Date: 04/30/2025
Certification Date: 04/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5141 W HESSLER RD STE D
MUNCIE IN
47304-7301
US

IV. Provider business mailing address

4326 S SCATTERFIELD RD # 202
ANDERSON IN
46013-2631
US

V. Phone/Fax

Practice location:
  • Phone: 765-231-6922
  • Fax:
Mailing address:
  • Phone: 765-606-9609
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name: JENIFER MUDD-CHAMBERLAIN
Title or Position: OWNER
Credential:
Phone: 765-231-6922